| Doctor Name: | JERRI LYN KETTMAN |
| NPI Number: | 1881750115 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNC |
| License Number: | |
| Business Practice Address: | Fort Harrison Vamc 1892 Williams Street Fort Harrison, MT - 59636 |
| Business Phone Number: | 4064477596 |
| Business Fax Number: | 4094477965 |
| Mailing Address: | 17 Bridger Mt Road South, CLANCY |
| State: | MT |
| Postal Code: | 59634 |
| Phone Number: | 4064430140 |
| Fax Number: | |
| NPI Enumeration Date: | 12/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |