Individual provider · Type 1 NPI

Kelli Anne Wall

Physician Assistant · Charlotte, NC

NPI number 1639760945 Active

Practice location

325 Hawthorne Ln Ste 100
Charlotte, NC 28204-2536

Call (704) 316-7760 Map

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice locations

  • 1450 Matthews Township Pkwy Ste 450, Matthews, NC 28105-5343 · (704) 384-8480
  • 14837 Cane Field Dr, Charlotte, NC 28273-8848 · (352) 942-4010

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Physician Assistant Primary 363A00000X0010-11928 (NC)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1639760945

Kelli Anne Wall's National Provider Identifier is 1639760945, issued on Jan 29, 2021. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Charlotte, NC. The record was last updated on Nov 14, 2025.