Provider Demographics
NPI:1043303795
Name:GOTT, CHARLOTTE ANNE (FNP)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:ANNE
Last Name:GOTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 COLLETON MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-8478
Mailing Address - Country:US
Mailing Address - Phone:704-616-9747
Mailing Address - Fax:
Practice Address - Street 1:980 COLLETON MEADOW DR
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:SC
Practice Address - Zip Code:29710-8478
Practice Address - Country:US
Practice Address - Phone:704-616-9747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily