Provider Demographics
NPI:1407440720
Name:KERNS, CLAYTON W (NREMT)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:W
Last Name:KERNS
Suffix:
Gender:M
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 SCOTCH RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:SC
Mailing Address - Zip Code:29709-1727
Mailing Address - Country:US
Mailing Address - Phone:843-623-3362
Mailing Address - Fax:843-623-6015
Practice Address - Street 1:109 SCOTCH RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:SC
Practice Address - Zip Code:29709-1727
Practice Address - Country:US
Practice Address - Phone:843-623-3362
Practice Address - Fax:843-623-6015
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC007245146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic