Provider Demographics
NPI:1487612503
Name:KERLIN, JUDY L (APN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:L
Last Name:KERLIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:MOELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1168 BEACON AVE
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2418
Mailing Address - Country:US
Mailing Address - Phone:609-597-6092
Mailing Address - Fax:609-597-7458
Practice Address - Street 1:1173 BEACON AVE STE B
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2531
Practice Address - Country:US
Practice Address - Phone:732-840-7500
Practice Address - Fax:732-840-2088
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC06027100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
003707Medicare ID - Type Unspecified
S46437Medicare UPIN