Individual
MARIANNE GRADELESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
G.O.N.P.
Contact information
Practice address
112 MEDICAL DR, ELIZABETH CITY, NC 27909-3361
(252) 338-2151
(252) 338-2505
Mailing address
4810 S CROATAN HWY, SUITE 250, NAGS HEAD, NC 27959-8508
(252) 261-4885
(252) 441-2641
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
017944
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7949645
—
NC
Enumeration date
01/16/2007
Last updated
04/14/2008
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