Provider Demographics
NPI:1497132963
Name:WINGATE UNIVERSITY
Entity Type:Organization
Organization Name:WINGATE UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:PRIVETTE
Authorized Official - Last Name:MCCASKILL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:704-233-8102
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:WINGATE
Mailing Address - State:NC
Mailing Address - Zip Code:28174
Mailing Address - Country:US
Mailing Address - Phone:704-233-8102
Mailing Address - Fax:704-233-8104
Practice Address - Street 1:109 N. CAMDEN RD
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174
Practice Address - Country:US
Practice Address - Phone:704-233-8102
Practice Address - Fax:704-233-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health