Individual
IRENE MARIA CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1510 HEBRON RD, HENDERSONVILLE, NC 28739-4794
(828) 693-8461
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5006781
NC
363L00000X
Nurse Practitioner
RN185501
GA
Other
Enumeration date
06/12/2012
Last updated
09/02/2024
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