EBONEE GRESHAM FNP
NPI 1508279837
Nurse Practitioner - Family in Decatur, GA

Active since June 04, 2014
4280 MEMORIAL DR STE D, DECATUR, GA 30032(678) 719-5525 Get Directions Write a Review

NPPES record last updated: April 16, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ebonee Gresham Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBONEE GRESHAM FNP (NPI 1508279837) is an individual family provider in Decatur, Georgia, licensed in Georgia (NP232368) and active in the NPI registry since June 2014.

NPPES Registry Identity

NPI1508279837
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameEBONEE GRESHAMCredential: FNP
Location Address4280 MEMORIAL DR STE DDecatur, GA 30032-1216
Mailing AddressPo Box 257Grayson, GA 30017-0005 · (678) 719-5525
Sole ProprietorNo
Enumeration DateJune 4, 2014
Last NPPES UpdateApril 16, 2026
NPPES CertifiedApril 16, 2026
NPI 1508279837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in GA · NP232368
Also ListedRegistered NurseTaxonomy 163W00000X · License 121515 (HI), 232368 (GA), 041577002 (IL), 202205404 (OR), 95291307 (CA), 924955 (NY)
4280 MEMORIAL DR STE D, Decatur, GA 30032

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
4280 MEMORIAL DR STE D
DECATUR, GA 30032

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebonee Gresham's NPI number?

The NPI number for Ebonee Gresham is 1508279837. It was assigned to this individual provider in the NPPES registry on June 4, 2014.

Where is Ebonee Gresham located?

Ebonee Gresham practices at 4280 Memorial Dr Ste D, Decatur, GA 30032. The listed phone number is (678) 719-5525.

What is Ebonee Gresham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Ebonee Gresham was last updated on April 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.