Individual
MRS. AUDREY JEAN HOCKEBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3623 LATROBE DR STE 216, CHARLOTTE, NC 28211
(704) 332-1291
(704) 332-5206
Mailing address
PO BOX 221249, CHARLOTTE, NC 28222-1249
(704) 332-1291
(704) 332-5206
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
0010-00997
NC
363A00000X
Physician Assistant
Primary
0010-00997
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1076748
NCCPA CERTIFICATION
—
Enumeration date
06/13/2007
Last updated
02/03/2023
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