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NPI Code Detail

MEDICARE: MRS. CRISTAL DAWN KERSEY

MEDICARE: MRS. CRISTAL DAWN KERSEY
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437441581
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CRISTAL DAWN KERSEY
Provider Business Mailing Address
First Line : PO BOX 1209
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69103-1209
Country : US
Telephone Number : 308-532-4860
Fax Number : 308-532-1157
Provider Business Practice Location Address
First Line : 110 N BAILEY AVE
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-5436
Country : US
Telephone Number : 308-532-4860
Fax Number : 308-532-1157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 10/30/2013

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