Individual
MARY C HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
457 N WENDOVER RD, CHARLOTTE, NC 28211-1064
(704) 817-3808
(877) 471-2522
Mailing address
457 N WENDOVER RD, CHARLOTTE, NC 28211-1064
(704) 817-3808
(877) 471-2522
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0009-00417
NC
363L00000X
Nurse Practitioner
Primary
900417
NC
363LA2200X
Adult Health Nurse Practitioner
900417
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003510
—
NC
Enumeration date
07/11/2006
Last updated
09/26/2025
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