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NPI Code Detail

MEDICARE: KELLY LYNN PEARSON FNP

MEDICARE:   KELLY LYNN PEARSON  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5007078NC
2363LF0000XFamily Nurse Practitioner5007078NC

General Provider Information

NPI Number : 1073608790
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY LYNN PEARSON FNP
Provider Business Mailing Address
First Line : 571 S ALLEN RD
Second Line :
City : FLAT ROCK
State : NC
Zip : 28731-9447
Country : US
Telephone Number : 828-692-6178
Fax Number : 828-692-2365
Provider Business Practice Location Address
First Line : 571 S ALLEN RD
Second Line :
City : FLAT ROCK
State : NC
Zip : 28731-9447
Country : US
Telephone Number : 828-692-6178
Fax Number : 828-692-2365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 05/13/2026

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Directions to “ KELLY LYNN PEARSON FNP” Practice Location

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