SearchNorth CarolinaPhysician Assistant

Lacey Wildeboer, PA

NPI 1477077089 · on the registry since 2017

Practice

Address
400 N Englewood Dr
Kenly, NC 27542
Phone
(919) 284-4149
Fax
(919) 284-6008
Organisation at this address
Johnston Memorial Hospital
Johnston Memorial Hospital Authority
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Additional practice sites

  • 7201 Us Highway 64 E, Knightdale, NC

Registry record

Primary taxonomy
Physician Assistant
363A00000X
Licence states on file
NC
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-10-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina