Individual provider · Type 1 NPI
Ebonee Gresham, FNP
Family Nurse Practitioner · Decatur, GA
NPI number
1508279837
Active
Practice location
4280 Memorial Dr Ste D
Decatur, GA 30032-1216
Mailing address
PO Box 257
Grayson, GA 30017-0005
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 121515 (HI) |
| Registered Nurse | 163W00000X | 232368 (GA) |
| Registered Nurse | 163W00000X | 041577002 (IL) |
| Family Nurse Practitioner Primary | 363LF0000X | NP232368 (GA) |
| Registered Nurse | 163W00000X | 202205404 (OR) |
| Registered Nurse | 163W00000X | 95291307 (CA) |
| Registered Nurse | 163W00000X | 924955 (NY) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1508279837
Ebonee Gresham, FNP's National Provider Identifier is 1508279837, issued on Jun 4, 2014. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Decatur, GA. The record was last updated on Apr 16, 2026.