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General NPI Number Information
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NPI Number | 1902647498
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Entity Type | Individual
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Provider Name | JENNIFER KERLEY PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 240 HIGHWAY 105 EXT STE 100
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City | BOONE
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State | NC
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Zip | 28607-4291
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Country | US
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Telephone | 828-264-7311
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Fax | 828-264-7907
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Provider Business Mailing Address
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Address Line | PO BOX 1490
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City | BOONE
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State | NC
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Zip | 28607-1490
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Country | US
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Telephone | 828-262-3886
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Fax | 833-665-5329
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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 | 5020349
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 284572
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License Number State | NC
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