Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000389 | CT |
NPI | 1104085687 |
---|---|
Provider Name | Dr. Nicole R Kerr |
First Address | Wallingford, CT 06492-2465 |
Second Address | Wallingford, CT 06492-2465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 17/10/2017 |