Provider Demographics
NPI:1851446728
Name:KEARNEY, PATRICIA (ANP GNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:ANP GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:147 COLUMBINE DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3112
Practice Address - Country:US
Practice Address - Phone:336-777-1200
Practice Address - Fax:336-777-0406
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC600048363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health