Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Pankow Jr., CRNP

Individual provider Acute Care Nurse Practitioner · NPI 1174366884

Charles Pankow Jr., CRNP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2024, 2 years ago. Practices with Lee Health System Inc, a 1,375-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida and Pennsylvania.

Years since qualifying
2
Licensed in
FL, PA
In the registry since
2024
Specialties on file
2
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

330 S Ninth St
Philadelphia, PA 19107-6103
Phone: (215) 662-3606
Fax: (215) 829-6606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 13685 Doctors Way Ste 350, Fort Myers, FL 33912-4347 — (239) 343-3800
  • 3132 Royal Gardens Ave, Fort Myers, FL 33916-4580 — (239) 994-3350

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP034276 (PA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence APRN11033483 (FL)

Record details

NPI number1174366884
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP
Sole proprietorNo
NPI enumeratedJune 18, 2024
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Lee Health System Inc — 1375 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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