Provider Demographics
NPI:1083214753
Name:KARELITZ, JILL (PMHNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:KARELITZ
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5963 PISGAH WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-2094
Mailing Address - Country:US
Mailing Address - Phone:704-553-8336
Mailing Address - Fax:704-235-1989
Practice Address - Street 1:5950 FAIRVIEW RD
Practice Address - Street 2:ST 322
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3104
Practice Address - Country:US
Practice Address - Phone:704-553-8336
Practice Address - Fax:704-553-8487
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC354720163W00000X
NC5019155363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse