# KELLY ELIZABETH EARNEST

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1366437238
- **Gender:** F
- **Credential:** CPNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 13454 | TN | — |
| 363LP0200X | Pediatric Nurse Practitioner | 13454 | TN | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | 3200P | KY | — |
| 363LP0200X | Pediatric Nurse Practitioner | RN115204 | GA | — |

## Other

- **Enumeration date:** 09/15/2005
- **Last updated:** 05/15/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000179284 | ID BLUE CROSS INSURANCE | KY |
| 01 | — | 50006858 | PASSPORT NON-PARTICIPATE | KY |
| 05 | — | 78004405 | — | KY |