Healthcare Provider Details

I. General information

NPI: 1881502813
Provider Name (Legal Business Name): CHARDAE WATLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 FAST PARK DR
RALEIGH NC
27617-4852
US

IV. Provider business mailing address

1439 BAILEY CIR
HIGH POINT NC
27262-3563
US

V. Phone/Fax

Practice location:
  • Phone: 919-213-0749
  • Fax:
Mailing address:
  • Phone: 856-408-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: