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General NPI Number Information
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NPI Number | 1265951727
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Entity Type | Individual
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Provider Name | KERI CAVALLO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 525 N TRYON ST STE 1600
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City | CHARLOTTE
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State | NC
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Zip | 28202-0213
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Country | US
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Telephone | 866-849-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 423 FAIR DR
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City | COSTA MESA
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State | CA
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Zip | 92626-6232
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Country | US
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Telephone |
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 850145
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License Number State | NV
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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 | 95006968
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10002048
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61368235
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1105908
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95006968
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024194424
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License Number State | VA
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5020061
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License Number State | NC
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 286807
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License Number State | AZ
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