Provider Demographics
NPI:1285475228
Name:KERNS, BRETT ALAN
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:ALAN
Last Name:KERNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 S GARNET DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1853
Mailing Address - Country:US
Mailing Address - Phone:417-848-5923
Mailing Address - Fax:
Practice Address - Street 1:1500 E 2700 S
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-4000
Practice Address - Country:US
Practice Address - Phone:417-848-5923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13576792-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health