MEDICARE: JESSICA HENSLEY KERR

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	1085409	TX
2	363LF0000X	Family Nurse Practitioner	3-000933	AL

General Provider Information

NPI Number	:	1629717160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA HENSLEY KERR

Provider Business Mailing Address
First Line	:	1818 COUNTY ROAD 258
Second Line	:
City	:	SANTA ANNA
State	:	TX
Zip	:	76878-6006
Country	:	US
Telephone Number	:	806-392-4344
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 N 2ND ST
Second Line	:
City	:	SANTA ANNA
State	:	TX
Zip	:	76878-2039
Country	:	US
Telephone Number	:	325-348-3566
Fax Number	:

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

Provider Enumeration Date	:	06/02/2022
Last Update Date	:	07/01/2022

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Directions to “ JESSICA HENSLEY KERR ” Practice Location

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