Healthcare Provider Details

I. General information

NPI: 1174446058
Provider Name (Legal Business Name): PRARTHNA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10515 MALLARD CREEK RD
CHARLOTTE NC
28262-9785
US

IV. Provider business mailing address

115 MEGANS CT
BENSALEM PA
19020-3142
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 401-287-0316
Mailing address:
  • Phone: 203-427-1091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5025283
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: