Provider Demographics
NPI:1427702596
Name:AUTRY, KERRY LYNN (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:LYNN
Last Name:AUTRY
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SILVER BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9802
Mailing Address - Country:US
Mailing Address - Phone:912-713-1112
Mailing Address - Fax:
Practice Address - Street 1:934 VANDORA SPRINGS RD
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3544
Practice Address - Country:US
Practice Address - Phone:919-977-7095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife