MEDICARE: KERRI ALLEN MSN, APRN-CNP, FNP-C

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	363LF0000X	Family Nurse Practitioner	1048603	TX

General Provider Information

NPI Number	:	1437827516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI ALLEN MSN, APRN-CNP, FNP-C

Provider Business Mailing Address
First Line	:	2930 FOULOIS PASS
Second Line	:
City	:	JBSA FT SAM HOUSTON
State	:	TX
Zip	:	78234-2557
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 SPURS LN STE 210
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1677
Country	:	US
Telephone Number	:	832-621-0699
Fax Number	:

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

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	09/02/2021

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