Individual
KELLY DEANNE JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8936 BLAKENEY PROFESSIONAL DR, CHARLOTTE, NC 28277-6660
(704) 943-3714
Mailing address
1450 PROFESSIONAL PARK DR STE 150, WINSTON SALEM, NC 27103-1307
(336) 607-8061
(336) 724-6123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12240
NC
363AM0700X
Medical Physician Assistant
PA9101452
FL
Other
Enumeration date
07/02/2006
Last updated
02/12/2025
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