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Individual
KIM KERRY NEELY
Active
Individual
KIM KERRY NEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102318
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
561976679
—
NC
Enumeration date
11/01/2006
Last updated
08/06/2026
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