MEDICARE: LINDA R KERLEY STNA

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	251J00000X	Nursing Care Agency	402254660320	OH

General Provider Information

NPI Number	:	1861011397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA R KERLEY STNA

Provider Business Mailing Address
First Line	:	1940 WESTBROOK RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-1858
Country	:	US
Telephone Number	:	937-250-5558
Fax Number	:

Provider Business Practice Location Address
First Line	:	1940 WESTBROOK RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-1858
Country	:	US
Telephone Number	:	937-250-5558
Fax Number	:

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

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	04/14/2020

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Directions to “ LINDA R KERLEY STNA” Practice Location

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