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Individual

MRS. ELYSA C. GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP, FNP-C

Contact information

Practice address
1914 J N PEASE PL STE 144, CHARLOTTE, NC 28262-4504
(704) 412-2802
(336) 203-2092
Mailing address
9311 JW CLAY BLVD, CHARLOTTE, NC 28262-5411
(704) 412-2802
(336) 203-2092

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5009266
NC
363LG0600X
Gerontology Nurse Practitioner
5009266
NC
363LP2300X
Primary Care Nurse Practitioner
5009266
NC

Other

Enumeration date
01/12/2016
Last updated
08/30/2024
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