Provider Demographics
NPI:1699827659
Name:KIRCHNER, KATHY LYNN (NP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:KIRCHNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 MILL CREEK RD STE D
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327-6506
Mailing Address - Country:US
Mailing Address - Phone:910-725-0809
Mailing Address - Fax:910-725-2018
Practice Address - Street 1:334 MILL CREEK RD STE D
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-6506
Practice Address - Country:US
Practice Address - Phone:910-725-0809
Practice Address - Fax:910-725-2018
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2018-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC204412363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003776Medicaid
NCFH4000520OtherFIRSTCAROLINACARE #
NCFH4000520OtherFIRSTCAROLINACARE #
NCP00454418Medicare PIN