Healthcare Provider Details

I. General information

NPI: 1528783578
Provider Name (Legal Business Name): VIRGINIE PADMORE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 WILKINSON BLVD
CHARLOTTE NC
28208-5631
US

IV. Provider business mailing address

3333 WILKINSON BLVD
CHARLOTTE NC
28208-5631
US

V. Phone/Fax

Practice location:
  • Phone: 704-393-7720
  • Fax: 704-398-3173
Mailing address:
  • Phone: 704-393-7720
  • Fax: 704-398-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26679
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5017880
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: