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General NPI Number Information
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NPI Number | 1780347724
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Entity Type | Individual
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Provider Name | KEVIN CLINTON KERRICK PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 201 E SAMPLE RD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-3502
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Country | US
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Telephone | 305-510-2302
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Fax |
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Provider Business Mailing Address
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Address Line | 8785 SW 165TH AVE STE 200-2010
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City | MIAMI
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State | FL
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Zip | 33193-5826
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Country | US
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Telephone | 305-510-2302
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Fax | 305-847-0418
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11015857
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License Number State | FL
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