Healthcare Provider Details

I. General information

NPI: 1740117464
Provider Name (Legal Business Name): OUTREACH HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5970 FAIRVIEW RD STE 600
CHARLOTTE NC
28210-2111
US

IV. Provider business mailing address

5970 FAIRVIEW RD STE 600
CHARLOTTE NC
28210-2111
US

V. Phone/Fax

Practice location:
  • Phone: 980-297-4936
  • Fax:
Mailing address:
  • Phone: 980-297-4936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRADLEY CURTIS TENNY
Title or Position: LEAD NP
Credential: AGACNP
Phone: 980-297-4936