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General NPI Number Information
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NPI Number | 1750334777
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Entity Type | Individual
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Provider Name | KENNETH EARL KERR CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 03/24/2014
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Provider Practice Location Address
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Address Line | 500 JEFFERSON ST
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City | WHITEVILLE
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State | NC
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Zip | 28472-3634
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Country | US
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Telephone | 910-642-1737
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 665 104 WEAVER DR
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City | LAKE WACCAMAW
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State | NC
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Zip | 28450-0665
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Country | US
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Telephone | 910-646-3714
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 151524
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License Number State | NC
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