Provider Demographics
NPI:1023486354
Name:BRINAGER, KERRY S (PA-C)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:S
Last Name:BRINAGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 TEAYS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-1318
Mailing Address - Country:US
Mailing Address - Phone:304-562-2002
Mailing Address - Fax:
Practice Address - Street 1:2 STONECREST DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-9391
Practice Address - Country:US
Practice Address - Phone:304-525-2273
Practice Address - Fax:304-525-2165
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1922363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant