Provider Demographics
NPI:1013588086
Name:PEARSON, KASHMERE LYNNETTE (MSN, APRN-CNP, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:KASHMERE
Middle Name:LYNNETTE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MSN, APRN-CNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1619
Mailing Address - Country:US
Mailing Address - Phone:614-500-3910
Mailing Address - Fax:830-521-4113
Practice Address - Street 1:14882 STATE ROUTE 13
Practice Address - Street 2:
Practice Address - City:THORNVILLE
Practice Address - State:OH
Practice Address - Zip Code:43076-8954
Practice Address - Country:US
Practice Address - Phone:740-242-2300
Practice Address - Fax:740-899-8070
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily