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General NPI Number Information
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NPI Number | 1437601721
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Entity Type | Individual
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Provider Name | KELLY FOX NP-C
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Gender | Female
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 13304 LEESVILLE CHURCH RD
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City | RALEIGH
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State | NC
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Zip | 27617-5206
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Country | US
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Telephone | 919-845-5276
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 BATTERHAYES RD APT 201
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City | RALEIGH
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State | NC
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Zip | 27615-2453
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Country | US
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Telephone | 215-740-8120
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Fax | 320-323-2369
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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 | 5009080
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License Number State | NC
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