Provider Demographics
NPI:1902213762
Name:WILKES COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:WILKES COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT SUPPORT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-651-7460
Mailing Address - Street 1:306 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-2854
Mailing Address - Country:US
Mailing Address - Phone:336-651-7460
Mailing Address - Fax:336-651-7472
Practice Address - Street 1:306 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2854
Practice Address - Country:US
Practice Address - Phone:336-651-7460
Practice Address - Fax:336-651-7472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC171075363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty