Individual
JOHANNA ELIZABETH HUGHES MENCEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7903 PROVIDENCE RD STE 100, CHARLOTTE, NC 28277-9763
(704) 316-4460
(704) 316-4466
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-3410
(704) 512-6851
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04958
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-04958
NORTH CAROLINA MEDICAL LICENSE
NC
05
—
1427280650
—
NC
05
—
2751PA
—
SC
Enumeration date
08/21/2009
Last updated
04/26/2023
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