Provider Demographics
NPI:1427327642
Name:HITE, KERRY HICKERSON (DPT)
Entity type:Individual
Prefix:MS
First Name:KERRY
Middle Name:HICKERSON
Last Name:HITE
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9194 RED BRANCH RD STE J
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2005
Mailing Address - Country:US
Mailing Address - Phone:410-997-2585
Mailing Address - Fax:
Practice Address - Street 1:9194 RED BRANCH RD STE J
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2005
Practice Address - Country:US
Practice Address - Phone:410-997-2585
Practice Address - Fax:419-997-2586
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23809225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic