Individual
JENNIFER LEIGH KORMELINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 S SHARON AMITY RD, STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
(704) 377-2687
Mailing address
501 S SHARON AMITY RD, STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
(704) 377-2687
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-03636
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154626869
—
NC
01
—
NC8494A
NC MEDICARE
NC
Enumeration date
01/12/2011
Last updated
12/29/2023
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