Healthcare Provider Details
I. General information
NPI: 1770386690
Provider Name (Legal Business Name): G&N MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3019 N CENTER ST
HICKORY NC
28601-1160
US
IV. Provider business mailing address
6521 BUENA VISTA CT
HICKORY NC
28601-9416
US
V. Phone/Fax
- Phone: 706-910-6708
- Fax:
- Phone: 706-910-6708
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
NATHANIEL
A
FULLER
Title or Position: MANAGER
Credential: PA-C
Phone: 706-910-6708