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Individual
KELLY ELIZABETH EARNEST
Active
Individual
KELLY ELIZABETH EARNEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
13454
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
13454
TN
363LP0200X
Pediatric Nurse Practitioner
3200P
KY
363LP0200X
Pediatric Nurse Practitioner
RN115204
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179284
ID BLUE CROSS INSURANCE
KY
01
—
50006858
PASSPORT NON-PARTICIPATE
KY
05
—
78004405
—
KY
Enumeration date
09/15/2005
Last updated
05/15/2014
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