Healthcare Provider Details

I. General information

NPI: 1598691370
Provider Name (Legal Business Name): CARLA MATTHEWS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 OLDENBURG LN
HOPE MILLS NC
28348-2996
US

IV. Provider business mailing address

2208 OLDENBURG LN
HOPE MILLS NC
28348-2996
US

V. Phone/Fax

Practice location:
  • Phone: 910-331-8576
  • Fax:
Mailing address:
  • Phone: 910-331-8576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number2128
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: