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General NPI Number Information
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NPI Number | 1609837301
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Entity Type | Individual
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Provider Name | EILEEN ANN KERR PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 2700 E LAKE ST #1100
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-1963
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Country | US
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Telephone | 612-873-8100
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Fax | 612-276-0177
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Provider Business Mailing Address
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Address Line | HENNEPIN HEALTHCARE EAST LAKE CLINIC 2700 E. LAKE ST #1100
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City | MPLS
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State | MN
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Zip | 55406
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Country | US
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Telephone | 612-873-6963
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Fax | 612-276-0188
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9402
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License Number State | MN
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