Healthcare Provider Details

I. General information

NPI: 1851409908
Provider Name (Legal Business Name): CHRISTINE ANN WORTHY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 05/29/2023
Certification Date: 05/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BLYTHE BLVD SUITE 300- ADULT CARDIOLOGY
CHARLOTTE NC
28203-5866
US

IV. Provider business mailing address

PO BOX 601067
CHARLOTTE NC
28260-1067
US

V. Phone/Fax

Practice location:
  • Phone: 704-373-0212
  • Fax: 704-373-1216
Mailing address:
  • Phone: 704-373-0212
  • Fax: 704-373-1216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number121230
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number960018
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: