Provider Demographics
NPI:1144696931
Name:MCANULTY, KERRI JEAN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:JEAN
Last Name:MCANULTY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:KERRI
Other - Middle Name:JEAN
Other - Last Name:GOODLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KERRI JEAN MCDANIEL
Mailing Address - Street 1:225 MARGARET AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3081
Mailing Address - Country:US
Mailing Address - Phone:724-522-5456
Mailing Address - Fax:
Practice Address - Street 1:225 MARGARET AVE STE 3
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3081
Practice Address - Country:US
Practice Address - Phone:724-522-5456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-15
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily