Healthcare Provider Details

I. General information

NPI: 1851215800
Provider Name (Legal Business Name): KAYLYNN LEPORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 N ELM ST
LUMBERTON NC
28358-3011
US

IV. Provider business mailing address

2604 N ELM ST
LUMBERTON NC
28358-3011
US

V. Phone/Fax

Practice location:
  • Phone: 910-360-1320
  • Fax:
Mailing address:
  • Phone:
  • Fax: 910-360-1320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number23083
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: