Healthcare Provider Details

I. General information

NPI: 1972462869
Provider Name (Legal Business Name): CATHERINE MARIE HEADLEY MSPH, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16526 NC HIGHWAY 87 W
TAR HEEL NC
28392-8608
US

IV. Provider business mailing address

16526 NC HIGHWAY 87 W
TAR HEEL NC
28392-8608
US

V. Phone/Fax

Practice location:
  • Phone: 877-935-5255
  • Fax:
Mailing address:
  • Phone: 877-935-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16960
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: