Healthcare Provider Details

I. General information

NPI: 1740450113
Provider Name (Legal Business Name): ROCHELE KIM HENRY SPIRES P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2008
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 MOREHEAD MEDICAL DR STE A
CHARLOTTE NC
28204-2990
US

IV. Provider business mailing address

716 BERKELEY RUN
SANDY SPRINGS GA
30342-4938
US

V. Phone/Fax

Practice location:
  • Phone: 919-801-3789
  • Fax:
Mailing address:
  • Phone: 919-801-3789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-00438
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: