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Individual

MS. CAROLINE J KERR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-A

Contact information

Practice address
4155 YELLOWSTONE AVE, PINE RIDGE MALL, POCATELLO, ID 83202-2345
(208) 238-0020
(208) 238-0021
Mailing address
4155 YELLOWSTONE AVE, PINE RIDGE MALL, POCATELLO, ID 83202-2345
(208) 238-0020
(208) 238-0021

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
AUD1215
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010137942
REGENCE BCBS
ID
01
000010150424
BLUE SHIELD OF ID
ID
01
AU373
BLUE CROSS OF ID
ID
Enumeration date
11/16/2006
Last updated
08/22/2007
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