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General NPI Number Information
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NPI Number | 1770067399
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Entity Type | Individual
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Provider Name | KATHLEEN ELISE BARBER PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 6005 HICKORY GROVE RD
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City | CHARLOTTE
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State | NC
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Zip | 28215-4129
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Country | US
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Telephone | 704-945-6480
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Fax | 704-945-6485
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Provider Business Mailing Address
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Address Line | 1951 OLD STEELE CREEK RD
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City | CHARLOTTE
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State | NC
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Zip | 28208-6080
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Country | US
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Telephone | 704-926-5434
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Fax |
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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 | 0010-08178
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License Number State | NC
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