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General NPI Number Information
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NPI Number | 1760891071
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Entity Type | Individual
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Provider Name | RITA HUSPEN KERR M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | 10877 CONDUCTOR BLVD
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City | SUTTER CREEK
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State | CA
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Zip | 95685-9687
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Country | US
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Telephone | 209-223-6407
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Fax | 209-267-9808
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Provider Business Mailing Address
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Address Line | 10877 CONDUCTOR BLVD
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City | SUTTER CREEK
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State | CA
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Zip | 95685-9687
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Country | US
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Telephone | 209-223-6407
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Fax | 209-267-9808
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G72170
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License Number State | CA
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