Healthcare Provider Details

I. General information

NPI: 1487442364
Provider Name (Legal Business Name): GRACE DYKE CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 DOCTORS PARK
LINCOLNTON NC
28092-4407
US

IV. Provider business mailing address

113 DOCTORS PARK
LINCOLNTON NC
28092-4407
US

V. Phone/Fax

Practice location:
  • Phone: 704-735-1441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberDYKE-2Y3FE
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: