Provider Demographics
NPI:1508563552
Name:KEARNEY, KEESHES RAGLAND
Entity type:Individual
Prefix:DR
First Name:KEESHES
Middle Name:RAGLAND
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 HOLIDAY LN LOT 51
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27537-3113
Mailing Address - Country:US
Mailing Address - Phone:252-767-9247
Mailing Address - Fax:252-598-2096
Practice Address - Street 1:945 W ANDREWS AVE STE F
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2504
Practice Address - Country:US
Practice Address - Phone:252-767-9247
Practice Address - Fax:252-598-0052
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC218717163WG0600X, 163WI0500X, 163WP2201X, 163WW0101X
NC50187812083P0901X, 363LA2200X, 363LC1500X, 363LG0600X, 363LP2300X, 363LW0102X, 363L00000X
251F00000X, 251S00000X, 261QI0500X
NC5018761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No251F00000XAgenciesHome Infusion
No251S00000XAgenciesCommunity/Behavioral Health
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health