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General NPI Number Information
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NPI Number | 1750269270
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Entity Type | Individual
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Provider Name | ELISCHA DESSALINES
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Gender | Female
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 445 DOLLEY MADISON RD STE 100
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City | GREENSBORO
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State | NC
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Zip | 27410-5166
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Country | US
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Telephone | 336-649-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 8217 OVATION DR
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City | CARY
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State | NC
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Zip | 27513-2644
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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 | 5022914
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License Number State | NC
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