Provider Demographics
NPI:1184419798
Name:WHITLEY, CHARLOTTE CLARK (FNP-C)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:CLARK
Last Name:WHITLEY
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 COMMERCE ST SW STE B
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8245
Mailing Address - Country:US
Mailing Address - Phone:828-326-3230
Mailing Address - Fax:
Practice Address - Street 1:1224 COMMERCE ST SW STE B
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8245
Practice Address - Country:US
Practice Address - Phone:828-326-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021983363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health