Provider Demographics
NPI:1164825956
Name:PUSEY, KYLE J (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:J
Last Name:PUSEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 NC HIGHWAY 42 W
Mailing Address - Street 2:STE 100
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5302
Mailing Address - Country:US
Mailing Address - Phone:919-359-0322
Mailing Address - Fax:
Practice Address - Street 1:2076 NC HIGHWAY 42 W
Practice Address - Street 2:STE 100
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5302
Practice Address - Country:US
Practice Address - Phone:919-359-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05300363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical