Individual
MRS. KRISTEN BETH MCKERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11189
CO
2251X0800X
Orthopedic Physical Therapist
11189
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11189
COLORADO PHYSICAL THERAPY LICENSE NUMBER
CO
Enumeration date
08/20/2009
Last updated
10/29/2013
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