Kelly Riley Dennis, APRN FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

146761 Issued in NC

Practice address

2310 Lull Water Dr
Fayetteville, NC 28306-4548

Phone

(910) 988-3919

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1043802259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 LULL WATER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283064548",
            "telephone_number": "910-723-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 LULL WATER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283064548",
            "telephone_number": "910-988-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "KELLY",
        "middle_name": "RILEY",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "146761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKayla Marie Demulling, LCSWA
• Demus Enterprise Services, LLC
• Frances L Denning, RN
• Kimberly Denning
• Diandra Dennis
• Stacey Katherine Dennis, MSW, LCSW
• Bradley Norman Dent, LCSW
• Osmani Deochand, M.D.
• Department of Veterans Affairs Medical Center
• Crystal Depietro, MSW, LCSW-A, CCM

• Family Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.