Individual
MIKE KERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
7707 AUSTIN RD, STOCKTON, CA 95215-8312
(209) 467-4508
Mailing address
PO BOX 1453, HUGHSON, CA 95326-1453
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
88124
CA
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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