Healthcare Provider Details

I. General information

NPI: 1386494490
Provider Name (Legal Business Name): LAUREN MARIE KLEPPER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 SUMMIT CROSSING PL
GASTONIA NC
28054-2192
US

IV. Provider business mailing address

4601 PARK RD STE 300
CHARLOTTE NC
28209-2290
US

V. Phone/Fax

Practice location:
  • Phone: 704-867-2333
  • Fax:
Mailing address:
  • Phone: 704-323-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-1439
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: