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General NPI Number Information
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NPI Number | 1013849793
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Entity Type | Individual
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Provider Name | KATHERINE LYNN WILSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/29/2026
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Last Update Date | 05/29/2026
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Provider Practice Location Address
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Address Line | 1025 MOREHEAD MEDICAL DR STE 600
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City | CHARLOTTE
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State | NC
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Zip | 28204-2969
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Country | US
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Telephone | 704-355-6649
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Fax | 704-446-4876
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Provider Business Mailing Address
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Address Line | 1025 MOREHEAD MEDICAL DR STE 600
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City | CHARLOTTE
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State | NC
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Zip | 28204-2969
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Country | US
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Telephone | 704-355-6649
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Fax | 704-446-4876
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-16617
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License Number State | NC
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