Basic Information
| Provider Information | |||||||||
| NPI: | 1801428974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCGRAIL | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | AGNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2605 BLUE RIDGE RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192779845 | ||||||||
| FaxNumber: | 9198639580 | ||||||||
| Practice Location | |||||||||
| Address1: | 2605 BLUE RIDGE RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192779845 | ||||||||
| FaxNumber: | 9198639580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2020 | ||||||||
| LastUpdateDate: | 02/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 5012812 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LA2200X | 5012812 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.