Provider Demographics
NPI:1477633477
Name:AVERY, KIRSTEN HILL (MD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:HILL
Last Name:AVERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KIRSTEN
Other - Middle Name:LILA
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:984-215-4110
Mailing Address - Fax:
Practice Address - Street 1:2605 BLUE RIDGE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607
Practice Address - Country:US
Practice Address - Phone:919-787-3448
Practice Address - Fax:919-232-0006
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900757207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013NAMedicaid
H03410Medicare UPIN