Provider Demographics
NPI:1295132470
Name:PURYEAR, LAKEESHA (DNP,MSN, APRN,AGPCNP)
Entity type:Individual
Prefix:DR
First Name:LAKEESHA
Middle Name:
Last Name:PURYEAR
Suffix:
Gender:F
Credentials:DNP,MSN, APRN,AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 PATRIOT RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2609 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-8032
Practice Address - Country:US
Practice Address - Phone:919-718-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC197031163WC0200X, 163WE0003X, 163WX0200X
NCAG7210053363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WX0200XNursing Service ProvidersRegistered NurseOncology