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General NPI Number Information
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NPI Number | 1255702064
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Entity Type | Individual
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Provider Name | KERI KATHLEEN RASSI ARNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 712 S OCEAN SHORE BLVD STE 107
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-3602
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Country | US
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Telephone | 386-631-5675
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Fax | 866-728-2444
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Provider Business Mailing Address
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Address Line | PO BOX 730875
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City | ORMOND BEACH
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State | FL
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Zip | 32173-0875
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Country | US
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Telephone | 386-631-5675
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Fax | 866-728-2444
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9262606
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License Number State | FL
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