Provider Demographics
NPI:1861763898
Name:KERNS, CHRISTINA (CRNA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KERNS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2297 NW 72ND TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1043
Mailing Address - Country:US
Mailing Address - Phone:954-987-8050
Mailing Address - Fax:
Practice Address - Street 1:2297 NW 72ND TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-1043
Practice Address - Country:US
Practice Address - Phone:954-987-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9166524163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical