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NPI Code Detail

MEDICARE: DR. NICOLE GASKINS GREYSHOCK MD

MEDICARE:  DR. NICOLE GASKINS GREYSHOCK  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician2011-00216NC
2207RE0101XEndocrinology, Diabetes & Metabolism Physician2011-00216NC

General Provider Information

NPI Number : 1063689826
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE GASKINS GREYSHOCK MD
Provider Business Mailing Address
First Line : PO BOX 96860
Second Line :
City : CHARLOTTE
State : NC
Zip : 28296-6860
Country : US
Telephone Number : 910-401-5425
Fax Number :
Provider Business Practice Location Address
First Line : 1340 WALTER REED RD STE 101
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-4451
Country : US
Telephone Number : 910-401-5425
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2008
Last Update Date : 06/03/2025

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Directions to “ DR. NICOLE GASKINS GREYSHOCK MD” Practice Location

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