Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | T03049 | MO |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | T03049 | MO |
N | 152WP0200X | Pediatric Optomitrist | T03049 | MO |
NPI | 1356334882 |
---|---|
Provider Name | Dr. Deborah Lynn Kerber |
First Address | Florissant, MO 63031-4923 |
Second Address | Florissant, MO 63031-4923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 23/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
318523602 | (05) | MO |
U33080 | (02) | MO |