Provider Demographics
NPI:1184419798
Name:WHITLEY, CHARLOTTE CLARK (FNP-C)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:CLARK
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:CLARK
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4601 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2290
Mailing Address - Country:US
Mailing Address - Phone:828-322-5172
Mailing Address - Fax:828-366-6963
Practice Address - Street 1:214 18TH ST SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1363
Practice Address - Country:US
Practice Address - Phone:828-322-5172
Practice Address - Fax:828-322-6963
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021983363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health