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General NPI Number Information
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NPI Number | 1730768896
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Entity Type | Individual
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Provider Name | KENNETH ALLAN LEVESQUE PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 327 1ST AVE NW
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City | HICKORY
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State | NC
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Zip | 28601-6122
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Country | US
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Telephone | 828-695-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 4431 JIM BEARD RD
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City | MAIDEN
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State | NC
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Zip | 28650-8586
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Country | US
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Telephone | 828-748-2875
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5014268
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License Number State | NC
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