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General NPI Number Information
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NPI Number | 1679154603
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Entity Type | Individual
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Provider Name | KENDALL LANE FLANIGAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 7903 PROVIDENCE RD STE 125
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City | CHARLOTTE
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State | NC
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Zip | 28277-8911
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Country | US
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Telephone | 704-727-7355
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Fax | 704-900-2216
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Provider Business Mailing Address
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Address Line | 801 YORK ST
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City | MANITOWOC
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State | WI
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Zip | 54220-4630
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Country | US
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Telephone | 920-663-9008
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Fax | 920-684-1439
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 2025-02105
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License Number State | NC
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