Individual
MS. KERRI NOEL BOOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, MMS, PA-C
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-2005
(570) 271-6812
(570) 271-6507
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA057054
PA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106722
PROVIDER ID
PA
Enumeration date
06/02/2014
Last updated
03/09/2016
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