Healthcare Provider Details

I. General information

NPI: 1457284200
Provider Name (Legal Business Name): LOGAN ELAINE RAMSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 MAIN STREET
BUIES CREEK NC
27506
US

IV. Provider business mailing address

555 CARTHAGE ST
SANFORD NC
27330-4104
US

V. Phone/Fax

Practice location:
  • Phone: 919-935-5284
  • Fax:
Mailing address:
  • Phone: 919-774-6518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16889
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: