Provider Demographics
NPI:1881734853
Name:PETRI, CHARLOTTE (RN)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:PETRI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 N JUSTICE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4217
Mailing Address - Country:US
Mailing Address - Phone:828-697-4187
Mailing Address - Fax:828-697-4488
Practice Address - Street 1:513 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4217
Practice Address - Country:US
Practice Address - Phone:828-697-4187
Practice Address - Fax:828-697-4488
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC187073163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse