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Grace Primary Care Pllc
Family Nurse Practitioner in Crestwood, Kentucky
NPI 1679058804

Grace Primary Care Pllc is a Family Nurse Practitioner based in Crestwood, KY and is specialized in Family. Grace Primary Care Pllc practices in Crestwood, KY. The NPI Number for Grace Primary Care Pllc is 1679058804 and holds a License No. (Kentucky).

The current practice location address for Grace Primary Care Pllc is 6520 W Highway 22, Crestwood, KY and can be reached out via phone at 502-241-8488.

Location: 6520 W Highway 22, Crestwood, KY, 40014-9305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1679058804
Provider Name
Grace Primary Care Pllc
Credential
Provider Entity Type
Organization
Address
6520 W Highway 22, Crestwood, KY, 40014-9305
Phone Number
502-241-8488
Fax Number
Provider Enumeration Date
10/03/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7100321490 05 KY
institution
Provider Business Practice Location Address Details
Address
6520 W Highway 22
City
Crestwood
State
Kentucky
Zip
40014
Phone Number
502-241-8488
Fax Number
person
Provider Business Mailing Address Details
Address
6520 W Highway 22
City
Crestwood
State
Kentucky
Zip
40014
Phone Number
502-241-8488
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
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Definition
Definition to come...
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