Scruggs, Kerry

Scruggs, Kerry is an individual health care provider with primary practice located at 3310 Patriot Dr , Tyler TX 75701-6606. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Scruggs, Kerry can be contacted via phone (903) 877-7777.

Contact Information

Primary practice address
3310 Patriot Dr Tyler TX 75701-6606
Phone: (903) 877-7777
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 534901 Texas

Profile Details

NPI number 1922080076
LBN Legal business name Scruggs, Kerry
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Sep 3rd, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922080076 NPPES
Texas MEDICAID 154069202

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