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NPI Code Detail

MEDICARE: CAROLYN SYLVIA KERANEN

MEDICARE: CAROLYN SYLVIA KERANEN
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
1224Z00000XOccupational Therapy AssistantOTA.0001004CO

General Provider Information

NPI Number : 1366023756
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN SYLVIA KERANEN
Provider Business Mailing Address
First Line : 7741 COUNTY ROAD 233
Second Line :
City : SILT
State : CO
Zip : 81652-9720
Country : US
Telephone Number : 406-871-0395
Fax Number :
Provider Business Practice Location Address
First Line : 851 E 5TH ST
Second Line :
City : RIFLE
State : CO
Zip : 81650-2941
Country : US
Telephone Number : 970-625-0842
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2021
Last Update Date : 04/16/2021

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Directions to “ CAROLYN SYLVIA KERANEN ” Practice Location

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