Individual
GWENDOLYN KERSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2600 CENTER ST NE OREGON STATE HOSPITAL, SALEM, OR 97301
(503) 945-2800
Mailing address
908 SW GAINES ST APT 11, PORTLAND, OR 97239-2959
(509) 991-4377
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201708298RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201906508NP-PP
OR
Other
Enumeration date
02/21/2019
Last updated
08/26/2019
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