Individual
TERRI J FORSYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4944
Mailing address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4944
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
300111
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007786662
—
VA
Enumeration date
06/10/2006
Last updated
08/05/2012
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