Provider Demographics
NPI:1043362890
Name:HEALTH PLUS BY NURSE PRACTITIONERS
Entity Type:Organization
Organization Name:HEALTH PLUS BY NURSE PRACTITIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:CASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:336-789-6503
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:TOAST
Mailing Address - State:NC
Mailing Address - Zip Code:27049-0130
Mailing Address - Country:US
Mailing Address - Phone:336-789-6503
Mailing Address - Fax:336-789-6687
Practice Address - Street 1:835 HWY 52 NORTH
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-2763
Practice Address - Country:US
Practice Address - Phone:336-789-6503
Practice Address - Fax:336-789-6687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC343936AMedicaid
27894OtherMEDCOST
NC02774OtherBCBS
27894OtherMEDCOST