Individual
MS. ELISABETH JANE KIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
410 MARKET ST STE 400, CHAPEL HILL, NC 27516-4061
(919) 966-7890
(984) 974-3692
Mailing address
PO BOX 746768, ATLANTA, GA 30374-6768
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12888
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001012888
NORTH CAROLINA MEDICAL BOARD
NC
01
—
1188137
NCCPA
—
Enumeration date
07/19/2021
Last updated
08/10/2026
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