Provider Demographics
NPI:1902015472
Name:UREVIG, KERRY JO (RN PHD)
Entity Type:Individual
Prefix:MISS
First Name:KERRY
Middle Name:JO
Last Name:UREVIG
Suffix:
Gender:F
Credentials:RN PHD
Other - Prefix:MRS
Other - First Name:KERRY
Other - Middle Name:JO
Other - Last Name:BIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1182
Mailing Address - Street 2:800 5TH ST S
Mailing Address - City:WALKER
Mailing Address - State:MN
Mailing Address - Zip Code:56484
Mailing Address - Country:US
Mailing Address - Phone:218-821-9294
Mailing Address - Fax:218-547-7232
Practice Address - Street 1:160 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1034
Practice Address - Country:US
Practice Address - Phone:218-998-3778
Practice Address - Fax:218-998-3187
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1050868163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse