Provider Demographics
NPI:1407061146
Name:CAROLINA FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:CAROLINA FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SPRATT
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:704-847-4000
Mailing Address - Street 1:1932 WEDDINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8318
Mailing Address - Country:US
Mailing Address - Phone:704-847-4000
Mailing Address - Fax:
Practice Address - Street 1:1932 WEDDINGTON RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-8318
Practice Address - Country:US
Practice Address - Phone:704-847-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201962261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ59848Medicare UPIN