Provider Demographics
NPI:1992314900
Name:JERGER, KRISTIN KAY (MD, LMBT)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:KAY
Last Name:JERGER
Suffix:
Gender:F
Credentials:MD, LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 TRAFALGAR LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5179
Mailing Address - Country:US
Mailing Address - Phone:919-830-1740
Mailing Address - Fax:
Practice Address - Street 1:138 TRAFALGAR LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5179
Practice Address - Country:US
Practice Address - Phone:919-830-1740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-26
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11719225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist