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General NPI Number Information
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NPI Number | 1306125224
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Entity Type | Organization
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Legal Business Name | SANGER HEART AND VASCULAR INSTITUTE
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 1001 BLYTHE BLVD # 300
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City | CHARLOTTE
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State | NC
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Zip | 28203-5866
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Country | US
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Telephone | 704-373-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 BLYTHE BOULEVARD, CHARLOTTE # 300
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City | CHARLOTTE
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State | NC
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Zip | 28203
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Country | US
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Telephone | 919-306-5992
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Fax |
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Authorized Official
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Title or Position | ADULT NURSE PRACTITIONER
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Name | MS. SAEDRA E PATELLA
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Credential | ANP
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Telephone | 704-373-0212
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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 | 5005274
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License Number State | NC
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