Provider Demographics
NPI:1184718199
Name:LAPPIN, KATHLEEN M (PA-C)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:LAPPIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 SPICE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604-8338
Mailing Address - Country:US
Mailing Address - Phone:828-266-5558
Mailing Address - Fax:
Practice Address - Street 1:1208 HICKORY BLVD SW STE 102
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-6461
Practice Address - Country:US
Practice Address - Phone:828-991-4660
Practice Address - Fax:828-991-4659
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-03049363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P48720Medicare UPIN