Healthcare Provider Details

I. General information

NPI: 1639891393
Provider Name (Legal Business Name): KARI RAE HUTCHINSON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARI RAE LANKFORD PA

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9325 JW CLAY BLVD STE 221
CHARLOTTE NC
28262-5411
US

IV. Provider business mailing address

PO BOX 19305
CHARLOTTE NC
28219-9305
US

V. Phone/Fax

Practice location:
  • Phone: 704-863-9050
  • Fax:
Mailing address:
  • Phone: 704-631-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: