Individual provider · NPI-1

Jacquelyn Charles

Contractor · Charlotte, NC

NPI number1710300397
StatusActive
Last updated in NPPESFeb 2, 2014

Details

NPI
1710300397
Entity type
Individual (NPI-1)
Name
Jacquelyn Charles
Sex
Female
Sole proprietor
No
Enumeration date
Feb 2, 2014
Last updated
Feb 2, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171W00000X Contractor––Yes

Practice location

4046 Glenlea Commons Dr
Charlotte, NC 28216-9515

Phone 706-412-3035

Mailing address

4046 Glenlea Commons Dr
Charlotte, NC 28216-9515

Phone 706-412-3035

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Contractor providers in Charlotte, NC