Individual
KERRA GREDNUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9000
(401) 533-9101
Mailing address
35 EMERSON ST APT 1, NEW BEDFORD, MA 02740-3657
(401) 952-3512
(401) 533-9101
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ES01788
—
RI
Enumeration date
05/12/2014
Last updated
05/12/2014
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