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General NPI Number Information
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NPI Number | 1194121624
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Entity Type | Individual
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Provider Name | LESA KERLEY CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/11/2014
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 1100 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2029
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Country | US
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Telephone | 417-256-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 1263 ELK ST
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City | FRANKLIN
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State | PA
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Zip | 16323-1312
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Country | US
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Telephone | 814-437-3674
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Fax | 814-437-3677
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP014345
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2017008862
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License Number State | MO
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