Individual
KERRY SCRUGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3310 PATRIOT DR, TYLER, TX 75701-6606
(903) 877-7777
Mailing address
PO BOX 847824, DALLAS, TX 75284-7824
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
534901
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154069202
—
TX
Enumeration date
11/15/2005
Last updated
09/03/2008
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