Healthcare Provider Details

I. General information

NPI: 1093324717
Provider Name (Legal Business Name): LAQUINTA PEELER KEE PHMNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 S LAFAYETTE ST UNIT 1
SHELBY NC
28150-5809
US

IV. Provider business mailing address

3016 CEDAR POINT DR
SHELBY NC
28150-8116
US

V. Phone/Fax

Practice location:
  • Phone: 704-419-9772
  • Fax: 704-419-2101
Mailing address:
  • Phone: 980-636-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2018079736
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2019080923
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: