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NPI Code Detail

MEDICARE: MISS KERRY ANN DANDRIDGE RN

MEDICARE: MISS KERRY ANN DANDRIDGE RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse129748OH
2163W00000XRegistered NurseRN.468696OH

General Provider Information

NPI Number : 1235388091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KERRY ANN DANDRIDGE RN
Provider Business Mailing Address
First Line : 1716 NORTH RD SE
Second Line :
City : WARREN
State : OH
Zip : 44484-2907
Country : US
Telephone Number : 330-539-3200
Fax Number :
Provider Business Practice Location Address
First Line : 1716 NORTH RD SE
Second Line :
City : WARREN
State : OH
Zip : 44484-2907
Country : US
Telephone Number : 330-539-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2008
Last Update Date : 02/05/2026

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