Doctor Name: | ELIZABETH GRACE |
NPI Number: | 1023445962 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 547453 |
Business Practice Address: | 501 E Washington Ave Navasota, TX - 778683001 |
Business Phone Number: | 9368256444 |
Business Fax Number: | |
Mailing Address: | 1515 Heritage Dr, Suite 110 MCKINNEY |
State: | TX |
Postal Code: | 750693256 |
Phone Number: | 8558602109 |
Fax Number: | |
NPI Enumeration Date: | 10/10/2013 |
NPI Last Update Date: | 10/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 547453 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |