MS. KELLY LYNN STOUT (NPI# 1780072330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780072330 |
| Entity Type | Individual |
| Full Name | MS. KELLY LYNN STOUT |
| Credential | CPNP |
| Practice Address |
1471 Jag Branch Blvd Ste 101 Kernersville NC 27284-6956 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 3365157420 |
| Mailing Telephone | 7043847834 |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
213338 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
19202 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP3486 | 05 | |
| NC | 1780072330 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 Blythe Blvd., Medical Center Plaza, Suite 200, Charlotte, NC 282035865 | 7043818840 | 7043818848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013395128 | Kelly Stout | Psychologist | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2015-05-08 |
| 1255673810 | Kelly Ann Stout | Social Worker | 2980 S Jones Blvd, Las Vegas, NV 89146-5656 | 2013-03-21 |
| 1154406007 | Kelly Ann Stout | Social Worker | 155 Inverness Dr W, Ste 200, Englewood, CO 80112-5095 | 2006-10-26 |
| 1083711881 | Kelly Best Stout | Pharmacist | 221 N Graham Hopedale Rd, Pharmacy, Burlington, NC 27217-2971 | 2006-09-20 |
| Street Address |
1471 JAG BRANCH BLVD STE 101 |
| City | KERNERSVILLE |
| State | NC |
| Zip Code | 27284-6956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740599778 | Forsyth Medical Group, LLC | Pediatrics | 1471 Jag Branch Blvd Ste 101, Kernersville, NC 27284-6956 | 2010-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549047 | Katie Lee Sherman | Student in an Organized Health Care Education/Training Program | 9372 Pumpkin Ridge Rd, Kernersville, NC 27284 | 2020-02-07 |
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1114490810 | Lindsey Sarvis | Social Worker | 2301 Lake Shore Reserve Court, Kernersville, NC 27284 | 2019-01-04 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1942786629 | Brea Anjanee' Washington | Nurse Practitioner | 1635 Nc 66 South, Suite 145, Kernersville, NC 27284 | 2018-07-16 |
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1902324304 | Susan Marie Garcia | Counselor | 822 Old Winston Road, Suite 5, Kernersville, NC 27284 | 2017-09-06 |
| 1871034603 | Ljp Lab LLC | Clinical Medical Laboratory | 495 Arbor Hill Rd Ste S, Kernersville, NC 27284 | 2017-03-13 |
| 1912446253 | Knew Era Consulting | Counselor | 335 Creekview Drive, Kernersville, NC 27284 | 2017-02-20 |
| 1144686593 | Amber Moore | Counselor | 822 Old Winston Rd, Suite 5, Kernersville, NC 27284 | 2016-01-14 |
| Find all providers in zip 27284 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770909699 | Jamila Palmer | Nurse Practitioner | 240 Broad St, Kernersville, NC 27284-2930 | 2014-03-17 |
| 1255762860 | Sharon Denise Allen | Nurse Practitioner | 815 Old Winston Rd, Kernersville, NC 27284-7124 | 2013-12-07 |
| 1417299603 | Brandi Foster Jordan | Nurse Practitioner | 861 Old Winston Rd, Kernersville, NC 27284-7140 | 2013-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594732 | Megan Hoekstra | Nurse Practitioner | 8358 Six Forks Rd Ste 204, Raleigh, NC 27615-5093 | 2020-10-04 |
| 1639713118 | Holly Hattler Barber | Nurse Practitioner | Unc Dept of Pediatrics 030 Macnider Hall Cb 7231, Chapel Hill, NC 27599-0001 | 2019-10-29 |
| 1437709565 | Molly Benson Miller | Nurse Practitioner | 101 Manning Dr Cb 7236, Chapel Hill, NC 27599-7236 | 2019-09-20 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1548814072 | Ashley Goodwin Friddle | Nurse Practitioner | 802 Green Valley Rd Ste 210, Greensboro, NC 27408-7099 | 2019-08-01 |
| 1740743129 | Jennifer W Farrow | Nurse Practitioner | 940 Se Cary Pkwy Ste 200, Cary, NC 27518-7417 | 2019-04-11 |
| 1538641147 | Taylor Rippy | Nurse Practitioner | 2304 Delaney Ave, Wilmington, NC 28403-6013 | 2018-08-30 |
| 1427544931 | Sheila L Mason | Nurse Practitioner | Wfbmc 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2018-07-09 |
| 1770099319 | Jillian Hernandez Sprague | Nurse Practitioner | 101 E Matthews St Ste 800, Matthews, NC 28105-5374 | 2017-12-19 |
| 1427587625 | Amanda Register | Nurse Practitioner | 110 E Park Dr, Beulaville, NC 28518-6916 | 2017-06-09 |
| Find all providers with the same taxonomy | ||||
| City | KERNERSVILLE |
| Zip Code | 27284 |
Please comment or provide details below to improve the information on MS. KELLY LYNN STOUT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.