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General NPI Number Information
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NPI Number | 1669284428
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Entity Type | Individual
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Provider Name | KAMILLA I ZETER PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 130 PROVIDENCE RD STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28207-1247
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Country | US
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Telephone | 704-333-9113
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Fax | 975-770-4333
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Provider Business Mailing Address
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Address Line | 130 PROVIDENCE RD STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28207-1247
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Country | US
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Telephone | 704-333-9113
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Fax | 704-333-9757
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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 | 0010-15367
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License Number State | NC
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