Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP30001028 | WA |
NPI | 1093795361 |
---|---|
Provider Name | Billie Jean Kerr |
First Address | Spokane, WA 99207-1240 |
Second Address | Spokane, WA 99207-1240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 20/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9609504 | DSHS (01) | WA |
S60096 | (02) | WA |