Provider Demographics
NPI:1700545753
Name:GWALTNEY, ANNETTE LORRAINE (DNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:LORRAINE
Last Name:GWALTNEY
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1453
Mailing Address - Country:US
Mailing Address - Phone:828-234-5999
Mailing Address - Fax:
Practice Address - Street 1:1075 E HUDSON BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1694
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCGWAL-J8F9N363LF0000X
NC5015522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily