Individual
GABRIELLE MORTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-9414
(704) 384-5735
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-3550
(336) 718-2553
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08174
NC
Other
Enumeration date
06/23/2018
Last updated
03/26/2021
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