Provider Demographics
NPI:1942412242
Name:CARTLEDGE, ELEANOR L (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:L
Last Name:CARTLEDGE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CRESCENT GREEN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518
Mailing Address - Country:US
Mailing Address - Phone:919-467-3211
Mailing Address - Fax:919-235-3094
Practice Address - Street 1:316 JUDD PLACE DR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2386
Practice Address - Country:US
Practice Address - Phone:919-557-2362
Practice Address - Fax:919-235-3094
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201367208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC590221CMedicaid