Provider Demographics
NPI:1437942448
Name:BRACH, KERI ANNE (APRN)
Entity type:Individual
Prefix:MS
First Name:KERI
Middle Name:ANNE
Last Name:BRACH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9760 S KEDZIE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-3184
Mailing Address - Country:US
Mailing Address - Phone:708-423-6209
Mailing Address - Fax:
Practice Address - Street 1:9760 S KEDZIE AVE STE 3
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-3184
Practice Address - Country:US
Practice Address - Phone:708-423-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041332770163WF0300X
IL209032417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WF0300XNursing Service ProvidersRegistered NurseFlight