1350 S KINGS DR
CHARLOTTE, NC 28207-2134 US PECOS Enrolled
Mary Blackwelder White
Nurse Practitioner
- CHARLOTTE, NC
- Phone: (704)-446-1422
- Last Updated 12/18/2023
Overview
Mary Blackwelder White is a Nurse Practitioner in the CHARLOTTE area. Mary Blackwelder White primary office location is at 1350 S KINGS DR and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1205851722 and the information was updated approximately 1 year ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| 300259 | NC |
No Identifiers found
| Taxonomy | State | Primary? |
|---|---|---|
| Nurse Practitioner - Taxonomy Code 363L00000X | NC | Y |
| Nurse Practitioner (Pediatrics) - Taxonomy Code 363LP0200X | NC | N |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | |
| PECOS Individual PAC ID: | |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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