Healthcare Provider Details

I. General information

NPI: 1326968942
Provider Name (Legal Business Name): JESSICA HAYNES MCELWEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 MOREHEAD MEDICAL DR
CHARLOTTE NC
28204-2839
US

IV. Provider business mailing address

620 ELLSWORTH RD
CHARLOTTE NC
28211-1432
US

V. Phone/Fax

Practice location:
  • Phone: 980-442-4363
  • Fax:
Mailing address:
  • Phone: 513-477-9988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number29924
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: