Provider Demographics
NPI:1689310187
Name:MCGALLIARD, JOSHUA TRAY LEE (AGNP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TRAY LEE
Last Name:MCGALLIARD
Suffix:
Gender:M
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 420
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5491
Mailing Address - Country:US
Mailing Address - Phone:984-974-2705
Mailing Address - Fax:
Practice Address - Street 1:2901 BLUE RIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6423
Practice Address - Country:US
Practice Address - Phone:919-784-6818
Practice Address - Fax:919-784-6828
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-08
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016468363LA2200X
NC297027163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine