Provider Demographics
NPI:1255560801
Name:KERCHER, KATHY JEAN (NP)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:JEAN
Last Name:KERCHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10011 S CENTENNIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4156
Mailing Address - Country:US
Mailing Address - Phone:801-566-5350
Mailing Address - Fax:801-282-2050
Practice Address - Street 1:3354 W 7800 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-4506
Practice Address - Country:US
Practice Address - Phone:801-282-2677
Practice Address - Fax:801-282-2050
Is Sole Proprietor?:No
Enumeration Date:2009-07-03
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7301103-4408363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner