Individual provider · Type 1 NPI
Kim B. Lackey, DNP, APRN, AGPCNP-BC
Primary Care Nurse Practitioner · Matthews, NC
NPI number
1699241752
Active
Practice location
434 N Trade St Ste 104
Matthews, NC 28105-1865
Fax (704) 771-1931
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 5011316 (NC) |
| Adult Health Nurse Practitioner | 363LA2200X | 5011316 (NC) |
| Gerontology Nurse Practitioner | 363LG0600X | 5011316 (NC) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1699241752
Kim B. Lackey, DNP, APRN, AGPCNP-BC's National Provider Identifier is 1699241752, issued on Oct 16, 2018. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Matthews, NC. The record was last updated on Feb 26, 2026.