Individual
MS. KERRI SHEA FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST, A.S.
Contact information
Practice address
7445 W. WASHINGTON AVE, 302, LAS VEGAS, NV 89128
(281) 742-9544
Mailing address
37 RAINBOW RD, CHEPACHET, RI 02814-4456
(401) 486-4878
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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