Individual
MS. KERRI A JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5115 CENTRE AVE, PITTSBURGH, PA 15232-1301
(412) 647-2811
Mailing address
428 LYNN ANN DR, NEW KENSINGTON, PA 15068-9382
(724) 882-3082
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA002234L
PA
Other
Enumeration date
03/03/2006
Last updated
03/30/2022
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