Provider Demographics
NPI:1194105494
Name:KERR, LYNN
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3517 KILBARRY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6968
Mailing Address - Country:US
Mailing Address - Phone:702-486-5597
Mailing Address - Fax:
Practice Address - Street 1:4538 W CRAIG RD
Practice Address - Street 2:SUITE 290
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2508
Practice Address - Country:US
Practice Address - Phone:702-486-5597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator