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General NPI Number Information
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NPI Number | 1043796014
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Entity Type | Individual
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Provider Name | CHARITY A MATHIS DNP
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Gender | Female
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 1115 HORNERS SAWMILL RD
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City | GERRARDSTOWN
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State | WV
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Zip | 25420-4276
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Country | US
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Telephone | 561-271-9244
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 HORNERS SAWMILL RD
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City | GERRARDSTOWN
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State | WV
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Zip | 25420-4276
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Country | US
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Telephone | 561-271-9244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 111213
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024183967
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024183967
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC007262
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 111213
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License Number State | WV
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