Provider Demographics
NPI:1033877246
Name:MCHARGUE, KARA DANIELLE (PA)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:DANIELLE
Last Name:MCHARGUE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:DANIELLE
Other - Last Name:PESCHOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 JULIAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-9078
Practice Address - Country:US
Practice Address - Phone:704-637-3373
Practice Address - Fax:704-637-0069
Is Sole Proprietor?:No
Enumeration Date:2021-12-05
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-11994363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant