Provider Demographics
NPI:1417719378
Name:PEDIATRICS PLUS
Entity Type:Organization
Organization Name:PEDIATRICS PLUS
Other - Org Name:PEDIATRICS PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CPNP
Authorized Official - Prefix:
Authorized Official - First Name:KERITH
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:ELROD
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CPNP
Authorized Official - Phone:256-375-6303
Mailing Address - Street 1:9 RED BAY LN
Mailing Address - Street 2:
Mailing Address - City:KITTY HAWK
Mailing Address - State:NC
Mailing Address - Zip Code:27949-3307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2420 S CROATAN HWY STE D
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9014
Practice Address - Country:US
Practice Address - Phone:256-375-6303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care