Provider Demographics
NPI:1497746093
Name:HOUGH, CHARLOTTE LEE (FNP)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:LEE
Last Name:HOUGH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S GUSTY WINDS DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-2265
Mailing Address - Country:US
Mailing Address - Phone:571-242-3031
Mailing Address - Fax:
Practice Address - Street 1:705 WH SMITH BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3752
Practice Address - Country:US
Practice Address - Phone:252-329-8482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015428363L00000X, 363LF0000X
VA0024166611363LF0000X
NC2015428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner