Healthcare Provider Details

I. General information

NPI: 1740174705
Provider Name (Legal Business Name): KELLY JEAN FRANCIS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 ORCHARD LAKE DR UNIT C
CHARLOTTE NC
28270-1475
US

IV. Provider business mailing address

108 S PADALI CT
MT HOLLY NC
28120-1177
US

V. Phone/Fax

Practice location:
  • Phone: 704-844-0181
  • Fax: 904-701-6279
Mailing address:
  • Phone: 605-441-6531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number280441
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5023589
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: