Provider Demographics
NPI:1902549116
Name:KERRIGAN, JAYME LYNNE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:LYNNE
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 N DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:MINERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17954-1706
Mailing Address - Country:US
Mailing Address - Phone:570-640-3328
Mailing Address - Fax:
Practice Address - Street 1:215 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-1900
Practice Address - Country:US
Practice Address - Phone:570-366-3722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018061225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist