Individual
MRS. KELLY RENEE' KERRIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
13313 SHORE LAKE TURN, CHESTERFIELD, VA 23838-3252
(804) 426-9028
Mailing address
13313 SHORE LAKE TURN, CHESTERFIELD, VA 23838-3252
(804) 426-9028
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001168810
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
OTHER
—
Enumeration date
06/23/2020
Last updated
06/23/2020
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