Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2011-00216 | NC |
N | 111NI0900X | Internist | 2011-00216 | NC |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 2011-00216 | NC |
NPI | 1063689826 |
---|---|
Provider Name | Dr. Nicole Gaskins Greyshock |
First Address | Fayetteville, NC 28304-3411 |
Second Address | Fayetteville, NC 28304-3411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 09/02/2015 |