Provider Demographics
NPI:1548637028
Name:FORRESTER, ENO (RN)
Entity type:Individual
Prefix:
First Name:ENO
Middle Name:
Last Name:FORRESTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5806 PROSPERITY CHURCH RD
Mailing Address - Street 2:SUITE A2-156
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2206
Mailing Address - Country:US
Mailing Address - Phone:704-277-3397
Mailing Address - Fax:704-947-7447
Practice Address - Street 1:5806 PROSPERITY CHURCH RD
Practice Address - Street 2:SUITE A2-156
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-2206
Practice Address - Country:US
Practice Address - Phone:704-277-3397
Practice Address - Fax:704-947-7447
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26171163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health