Healthcare Provider Details

I. General information

NPI: 1295037299
Provider Name (Legal Business Name): KAREN NORRIS WHITEHEAD ANP, FNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 01/14/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 COWELL FARM RD
WASHINGTON NC
27889-3431
US

IV. Provider business mailing address

1380 COWELL FARM RD
WASHINGTON NC
27889-3431
US

V. Phone/Fax

Practice location:
  • Phone: 252-946-2101
  • Fax: 252-975-0959
Mailing address:
  • Phone: 252-946-2101
  • Fax: 252-975-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5004984
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: