Provider Demographics
NPI:1962237685
Name:CHRISKERR LLC
Entity type:Organization
Organization Name:CHRISKERR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-986-0185
Mailing Address - Street 1:5338 CHESTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:AVE MARIA
Mailing Address - State:FL
Mailing Address - Zip Code:34142-5074
Mailing Address - Country:US
Mailing Address - Phone:239-986-0185
Mailing Address - Fax:
Practice Address - Street 1:5338 CHESTERFIELD DR
Practice Address - Street 2:
Practice Address - City:AVE MARIA
Practice Address - State:FL
Practice Address - Zip Code:34142-5074
Practice Address - Country:US
Practice Address - Phone:239-986-0185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty