Provider Demographics
NPI:1417176579
Name:KEARLEY, CORA PAULETTE (NP)
Entity Type:Individual
Prefix:MRS
First Name:CORA
Middle Name:PAULETTE
Last Name:KEARLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 PALADIN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7826
Mailing Address - Country:US
Mailing Address - Phone:252-751-8880
Mailing Address - Fax:252-752-3084
Practice Address - Street 1:608 AIRPORT RD # A
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-8210
Practice Address - Country:US
Practice Address - Phone:252-523-8513
Practice Address - Fax:252-523-9395
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35832363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC35832OtherMEDICAL LICENSE NUMBER