Provider Demographics
NPI:1215116462
Name:FOX, KERRY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:ANN
Last Name:FOX
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11000 PRAIRIE LAKES DR
Mailing Address - Street 2:SUITE 460
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3885
Mailing Address - Country:US
Mailing Address - Phone:952-943-0836
Mailing Address - Fax:952-943-0837
Practice Address - Street 1:11000 PRAIRIE LAKES DRIVE
Practice Address - Street 2:SUITE 460
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3434
Practice Address - Country:US
Practice Address - Phone:952-943-0836
Practice Address - Fax:952-943-0837
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-26
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Provider Licenses
StateLicense IDTaxonomies
MN348072084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry