Provider Demographics
NPI:1760428270
Name:ACHARD, MALINDA LOU (PA)
Entity Type:Individual
Prefix:
First Name:MALINDA
Middle Name:LOU
Last Name:ACHARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1908
Mailing Address - Country:US
Mailing Address - Phone:828-135-0369
Mailing Address - Fax:828-538-2277
Practice Address - Street 1:188 CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-513-0369
Practice Address - Fax:828-538-2277
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102956363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2338949Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER