Addison, Kera Beth
Addison, Kera Beth is an sole proprietor health care provider with primary practice located at 1625 S Main St , Malvern AR 72104-5600. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Addison, Kera Beth can be contacted via phone (501) 332-1818.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | OTR2220 | Arkansas |
Profile Details
| NPI number | 1063666105 |
|---|---|
| LBN Legal business name | Addison, Kera Beth |
| Credentials | MS, OTR/L |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 14th, 2008 |
| Last updated | Jun 24th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063666105 | NPPES |
| Arkansas | MEDICAID | 175282721 |
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