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General NPI Number Information
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NPI Number | 1063378008
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Entity Type | Individual
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Provider Name | ERNEST ALONZA GORHAM APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 01/03/2026
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Last Update Date | 01/03/2026
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Provider Practice Location Address
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Address Line | 809 TIFFANY BLVD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-1812
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Country | US
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Telephone | 866-272-7826
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Fax |
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Provider Business Mailing Address
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Address Line | 3341 NC HIGHWAY 33 W
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City | GREENVILLE
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State | NC
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Zip | 27834-9346
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 298192
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License Number State | NC
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