Healthcare Provider Details

I. General information

NPI: 1588556708
Provider Name (Legal Business Name): CHARLOTTE JULIANA ZINK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 N MAIN ST
HIGH POINT NC
27262-7830
US

IV. Provider business mailing address

380 KNOLLWOOD ST STE H
WINSTON SALEM NC
27103-1865
US

V. Phone/Fax

Practice location:
  • Phone: 336-884-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-15544
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: