Provider Demographics
NPI:1528299484
Name:KERN, KAREN DENISE (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DENISE
Last Name:KERN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 EDEN WAY N
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2768
Mailing Address - Country:US
Mailing Address - Phone:757-953-6375
Mailing Address - Fax:757-953-6317
Practice Address - Street 1:2005 KNIGHT LANE
Practice Address - Street 2:BLDG. H
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32212-0140
Practice Address - Country:US
Practice Address - Phone:202-762-3194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist