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General NPI Number Information
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NPI Number | 1598517500
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Entity Type | Individual
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Provider Name | GRACI ELIZABETH YORK FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 08/24/2025
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Provider Practice Location Address
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Address Line | 624 TEBEAU ST
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City | WAYCROSS
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State | GA
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Zip | 31501-4728
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Country | US
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Telephone | 912-809-6052
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Fax |
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Provider Business Mailing Address
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Address Line | 5268 PINE VIEW RD
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City | WAYCROSS
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State | GA
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Zip | 31503-9200
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Country | US
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Telephone | 912-816-7414
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN287067
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License Number State | GA
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