Provider Demographics
NPI:1538452206
Name:KERR, LISA GALEN (PA-C)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:GALEN
Last Name:KERR
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5201 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7708
Mailing Address - Country:US
Mailing Address - Phone:214-590-6310
Mailing Address - Fax:214-590-6377
Practice Address - Street 1:1904 S MAIN ST STE 114
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5030
Practice Address - Country:US
Practice Address - Phone:919-758-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2021-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08971363A00000X
NC0010-11615363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant