Dodge, Charlene B
Dodge, Charlene B is an individual health care provider with primary practice located at 1718 E 4Th St Suite 201, Charlotte NC 28204-3261. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Dodge, Charlene B can be contacted via phone (704) 384-0560.Contact Information
Primary practice address
1718 E 4Th St Suite 201
Charlotte NC 28204-3261
Phone: (704) 384-0560
Fax: (704) 384-0561
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology | 363LX0001X | 800048 | North Carolina |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 800048 | North Carolina |
Profile Details
NPI number | 1942369996 |
---|---|
LBN Legal business name | Dodge, Charlene B |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 6th, 2006 |
Last updated | Jul 8th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1942369996 | NPPES |
North Carolina | MEDICAID | 7005695 |
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