Provider Demographics
NPI:1952588220
Name:CHARLES, CAROL E (NP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:E
Last Name:CHARLES
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Gender:F
Credentials:NP
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Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-424-6893
Mailing Address - Fax:678-819-0357
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 350
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-424-6893
Practice Address - Fax:678-819-0357
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN147630363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health