Provider Demographics
NPI:1235915497
Name:LECHTENBERGER, CARRIE L (APRN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:LECHTENBERGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 DUNWOODY DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-0045
Mailing Address - Country:US
Mailing Address - Phone:949-375-3802
Mailing Address - Fax:
Practice Address - Street 1:1000 HEALING WAY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-4969
Practice Address - Country:US
Practice Address - Phone:980-993-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE94021363LF0000X
NE115021363LF0000X
NC5020233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily