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General NPI Number Information
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NPI Number | 1194854778
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Entity Type | Individual
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Provider Name | CATHERINE JANELL TEWOLDE CNP
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 332 SAM NEWELL RD
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City | MATTHEWS
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State | NC
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Zip | 28105-6566
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Country | US
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Telephone | 704-302-8583
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Fax | 704-302-8548
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Provider Business Mailing Address
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Address Line | 8521 TONAWANDA DR
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City | CHARLOTTE
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State | NC
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Zip | 28277-1802
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Country | US
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Telephone | 704-668-1555
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5003379
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License Number State | NC
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