Lackey, Kim B

Lackey, Kim B is an individual health care provider with primary practice located at 434 N Trade St Ste 104 , Matthews NC 28105-1865. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Lackey, Kim B can be contacted via phone (704) 246-3936.

Contact Information

Primary practice address
434 N Trade St Ste 104 Matthews NC 28105-1865
Phone: (704) 246-3936
Fax: (704) 771-1931
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 5011316 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 5011316 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 5011316 North Carolina

Profile Details

NPI number 1699241752
LBN Legal business name Lackey, Kim B
Credentials DNP, APRN, AGPCNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2018
Last updated Feb 26th, 2026 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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