Kellie Duvall Souther
Kellie Duvall Souther is a Nurse Practitioner in Mocksville, North Carolina. Qualified in 2018, 8 years ago. Practices with Wake Forest University Health Sciences, a 2,621-clinician group and accepts Medicare assignment. Licensed in North Carolina.
- Years since qualifying
- 8
- Licensed in
- NC
- In the registry since
- 2018
- Specialties on file
- 2
Practice location Address checks out
1188 Yadkinville RdMocksville, NC 27028-2037
Phone: (336) 716-7435
Fax: (336) 702-9277
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence 5011023 (NC) |
|---|---|
| Family Nurse Practitioner | Taxonomy 363LF0000X · Licence 5011023 (NC) |
Record details
| NPI number | 1558846527 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 26, 2018 |
| Last updated in NPPES | December 5, 2023 |
| Certification date | December 5, 2023 |
| Mailing address | 100 Kimel Forest Dr, Winston Salem, NC 27103-6074 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2018 (8 years in practice) |
| Group practice | Wake Forest University Health Sciences — 2621 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Mocksville
-
Lisa Gayle Harris, FNP-C
1188 Yadkinville Rd, Mocksville, NC 27028-2037 · (336) 716-7435
-
Nathaniel S Harvey
1102 Yadkinville Rd Ste B, Mocksville, NC 27028-2037 · (336) 296-3101
-
Pamela Lyn Hutton, FNP
1188 Yadkinville Rd, Mocksville, NC 27028-2037 · (336) 716-7435
-
Andora Nicholson, FNP-C
101 Wilkesboro St, Mocksville, NC 27028-2321 · (336) 753-0805