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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942369996 NPPES
North Carolina MEDICAID 7005695

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