Healthcare Provider Details

I. General information

NPI: 1275231672
Provider Name (Legal Business Name): JENNIFER LYNN KERLEY DNP, RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 TATE BLVD SE STE 186
HICKORY NC
28602-4042
US

IV. Provider business mailing address

3347 SHADY ROUGH RD
CONNELLY SPRINGS NC
28612-7795
US

V. Phone/Fax

Practice location:
  • Phone: 828-449-8458
  • Fax: 828-323-8348
Mailing address:
  • Phone: 828-851-7782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberKERL-L94U2
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: