Individual
MS. LISA KELLY KEARNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,CCC-SLP
Contact information
Practice address
2320 SHORE DR., MOREHEAD CITY, NC 28557
(252) 342-2907
(252) 726-1458
Mailing address
PO BOX 2218, MOREHEAD CITY, NC 28557-2218
(252) 342-2907
(252) 726-1458
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4278
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1355H
BCBS NCHEALTHCHOICE ID
NC
05
—
7412045
—
NC
Enumeration date
01/30/2007
Last updated
07/08/2007
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