Individual
KELLY ANNE GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5500 EXECUTIVE CENTER DR STE 206, CHARLOTTE, NC 28212-8864
(984) 777-9940
(877) 794-5929
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08262
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801308929
—
NC
Enumeration date
10/30/2017
Last updated
06/23/2025
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