Provider Demographics
NPI:1619587540
Name:ABRAHAM, JOSEY (DNP)
Entity Type:Individual
Prefix:DR
First Name:JOSEY
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 AIKEN HUNT CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-8407
Mailing Address - Country:US
Mailing Address - Phone:803-238-2517
Mailing Address - Fax:
Practice Address - Street 1:1221 BROADWAY STE 700
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1898
Practice Address - Country:US
Practice Address - Phone:415-972-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily