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NPI Code Detail

MEDICARE: MICHELLE KERN

MEDICARE: MICHELLE KERN
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
1225200000XPhysical Therapy Assistant06004150AIN

General Provider Information

NPI Number : 1639613250
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE KERN
Provider Business Mailing Address
First Line : 7012 MORNINGKNOLL DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-7751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7012 MORNINGKNOLL DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-7751
Country : US
Telephone Number : 260-348-1432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2016
Last Update Date : 12/16/2016

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Directions to “ MICHELLE KERN ” Practice Location

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