Doctor Name: | MR. NATHAN PAUL KERSEY |
NPI Number: | 1922216142 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 4833 |
Business Practice Address: | 1174 Screamer Rd Lynnville, TN - 384728153 |
Business Phone Number: | 6194562290 |
Business Fax Number: | |
Mailing Address: | 1174 Screamer Rd, LYNNVILLE |
State: | TN |
Postal Code: | 384728153 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/20/2007 |
NPI Last Update Date: | 03/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 4833 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |