LISA M KELLEY N.P. NPI 1669457420

NPI Information

NPI: 1669457420
Provider Name: LISA M KELLEY, N.P.
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

Address:
2711 RANDOLPH RD
SUITE 100
CHARLOTTE, NC
ZIP 28207
Phone: (704) 342-9550
Get Directions

Lisa M Kelley, N.P. is a women's health nurse practitioner in Charlotte, NC. Lisa M Kelley, N.P. NPI is 1669457420. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2711 RANDOLPH RD
SUITE 100
CHARLOTTE, NC
ZIP 28207-034
Phone: (704) 342-9550
Fax: (704) 377-0353

The enumeration date for this NPI number is 12/14/2005 and was last updated on 3/2/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health	0024165508	VIRGINIA	No
2	363LW0102X	Nurse Practitioner	Women's Health	0050-03621	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P84088	MEDICARE UPIN
2	000974H83	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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