Provider Demographics
NPI:1184468142
Name:TESSNER, MEREDITH FERGUSON (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:FERGUSON
Last Name:TESSNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MEREDITH
Other - Middle Name:MARGARET
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4601 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2290
Mailing Address - Country:US
Mailing Address - Phone:704-323-2918
Mailing Address - Fax:
Practice Address - Street 1:441 MCALISTER RD STE 1100A
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4127
Practice Address - Country:US
Practice Address - Phone:704-732-4064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-14262363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant