Provider Demographics
NPI:1215717590
Name:KERR, AMBEREE LANAYE (LPN)
Entity type:Individual
Prefix:
First Name:AMBEREE
Middle Name:LANAYE
Last Name:KERR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 TOWER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:MAYBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12543-1547
Mailing Address - Country:US
Mailing Address - Phone:843-992-6241
Mailing Address - Fax:
Practice Address - Street 1:502 TOWER AVE APT 2
Practice Address - Street 2:
Practice Address - City:MAYBROOK
Practice Address - State:NY
Practice Address - Zip Code:12543-1547
Practice Address - Country:US
Practice Address - Phone:843-992-6241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346412164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse