MEDICARE: KERI TUTTERROW

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
1	101YM0800X	Mental Health Counselor	IMH28003	FL

General Provider Information

NPI Number	:	1346102159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI TUTTERROW

Provider Business Mailing Address
First Line	:	2101 MCGREGOR BLVD UNIT 101
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3480
Country	:	US
Telephone Number	:	239-540-1155
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 MCGREGOR BLVD UNIT 101
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3480
Country	:	US
Telephone Number	:	239-540-1155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ KERI TUTTERROW ” Practice Location

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