Healthcare Provider Details

I. General information

NPI: 1437947553
Provider Name (Legal Business Name): VICTORIA GRACE GIORDANO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HAWTHORNE LN STE 300
CHARLOTTE NC
28204-2536
US

IV. Provider business mailing address

22212 COUNTRY CLUB CIR
CORNELIUS NC
28031-6622
US

V. Phone/Fax

Practice location:
  • Phone: 704-944-6330
  • Fax: 704-337-8387
Mailing address:
  • Phone: 571-528-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16213
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: