Individual
EILEEN ANN KERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2700 E LAKE ST, #1100, MINNEAPOLIS, MN 55406-1963
(612) 873-8100
(612) 276-0177
Mailing address
HENNEPIN HEALTHCARE EAST LAKE CLINIC, 2700 E. LAKE ST #1100, MPLS, MN 55406
(612) 873-6963
(612) 276-0188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9402
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-20856
MEDICA
MN
01
—
123263
UCARE
MN
05
—
507428200
—
MN
01
—
77B41KE
BCBS
MN
01
—
HP30472
HEALTH PARTNERS
MN
01
—
NA9021020591
PREFERRED ONE
MN
Enumeration date
03/31/2006
Last updated
11/21/2018
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