Individual
ANNA LILLIAN HALLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4741 RANDOLPH RD STE 100&200, CHARLOTTE, NC 28211-2919
(704) 365-6730
(704) 365-6731
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-14039
NC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/02/2023
Last updated
09/11/2025
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