Individual
MS. KATHERINE GRAHAM FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15825 BALLANTYNE MEDICAL PL, SUITE 240, CHARLOTTE, NC 28277-4652
(704) 544-5245
(704) 544-5250
Mailing address
15825 BALLANTYNE MEDICAL PL, SUITE 240, CHARLOTTE, NC 28277-4652
(704) 544-5245
(704) 544-5250
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
103556
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0532PA
—
SC
Enumeration date
03/19/2007
Last updated
08/16/2024
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