MEDICARE: KYLIE SAMANTHA LEEK FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5021940	NC

General Provider Information

NPI Number	:	1134927064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE SAMANTHA LEEK FNP-BC

Provider Business Mailing Address
First Line	:	111 RIVERSIDE DR
Second Line	:
City	:	HAYESVILLE
State	:	NC
Zip	:	28904-7509
Country	:	US
Telephone Number	:	828-557-8163
Fax Number	:

Provider Business Practice Location Address
First Line	:	427 HARRISON AVE
Second Line	:
City	:	FRANKLIN
State	:	NC
Zip	:	28734-2580
Country	:	US
Telephone Number	:	828-524-7337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2025
Last Update Date	:	06/02/2026

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