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NPI Code Detail

MEDICARE: JESSLYNNE KELLEY LILLARD FNP

MEDICARE:   JESSLYNNE KELLEY LILLARD  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
1363LF0000XFamily Nurse PractitionerF06231016NC
2363LF0000XFamily Nurse Practitioner5018428NC

General Provider Information

NPI Number : 1659059186
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSLYNNE KELLEY LILLARD FNP
Provider Business Mailing Address
First Line : 516 RIVERSIDE DR
Second Line :
City : MORGANTON
State : NC
Zip : 28655-3727
Country : US
Telephone Number : 828-448-9391
Fax Number :
Provider Business Practice Location Address
First Line : 712 JAMESTOWN RD
Second Line :
City : MORGANTON
State : NC
Zip : 28655-9216
Country : US
Telephone Number : 828-608-0953
Fax Number : 828-608-0954
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2023
Last Update Date : 10/02/2023

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Directions to “ JESSLYNNE KELLEY LILLARD FNP” Practice Location

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