Provider Demographics
NPI:1053562421
Name:LINDO, KERRY ANN (RN)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:ANN
Last Name:LINDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E 190TH ST APT 46
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-4542
Mailing Address - Country:US
Mailing Address - Phone:917-645-4589
Mailing Address - Fax:
Practice Address - Street 1:55 E 190TH ST APT 46
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-4542
Practice Address - Country:US
Practice Address - Phone:917-645-4589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY590210163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse