Provider Demographics
NPI:1427636513
Name:KERR, JASMINE (QPPMH,CNA)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:QPPMH,CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 RUTHERS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5395
Mailing Address - Country:US
Mailing Address - Phone:804-397-8907
Mailing Address - Fax:
Practice Address - Street 1:221 RUTHERS RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5395
Practice Address - Country:US
Practice Address - Phone:804-397-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA862944550Medicaid