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General NPI Number Information
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NPI Number | 1386778066
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Entity Type | Individual
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Provider Name | KERRI K DOUCETTE R.N., R.D., C.D.E.
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 20218 COLONY POINT LN
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City | CORNELIUS
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State | NC
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Zip | 28031-6011
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Country | US
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Telephone | 603-361-9620
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Fax |
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Provider Business Mailing Address
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Address Line | 20218 COLONY POINT LN
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City | CORNELIUS
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State | NC
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Zip | 28031-6011
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Country | US
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Telephone | 603-361-9620
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Fax |
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L003934
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 97278
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License Number State | NC
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