Provider Demographics
NPI:1538873484
Name:GRAHAM, HILLARY WHITE (FNP-C)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:WHITE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:ALLISON
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1490 BACK CREEK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT ULLA
Mailing Address - State:NC
Mailing Address - Zip Code:28125-9750
Mailing Address - Country:US
Mailing Address - Phone:704-213-0808
Mailing Address - Fax:
Practice Address - Street 1:1490 BACK CREEK CHURCH RD
Practice Address - Street 2:
Practice Address - City:MOUNT ULLA
Practice Address - State:NC
Practice Address - Zip Code:28125-9750
Practice Address - Country:US
Practice Address - Phone:704-213-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCGRAH-LZ1N0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily