Head, Mary C

Head, Mary C is an individual health care provider with primary practice located at 19485 Old Jetton Rd Suite 100, Cornelius NC 28031-6582. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Head, Mary C can be contacted via phone (704) 384-1775.

Contact Information

Primary practice address
19485 Old Jetton Rd Suite 100 Cornelius NC 28031-6582
Phone: (704) 384-1775
Fax: (704) 384-1776
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 0009-00417 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 900417 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 900417 North Carolina

Profile Details

NPI number 1699700484
LBN Legal business name Head, Mary C
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jun 21st, 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 1699700484 NPPES
North Carolina MEDICAID 7003510

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