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Grace Healthcare Services INC

Nurse Practitioner, Psych/Mental Health in Frederick, MD. Organization (NPI-2).

NPI number1902581978
StatusActive
Last updated in NPPESJun 20, 2023

Details

NPI
1902581978
Entity type
Organization (NPI-2)
Legal business name
Grace Healthcare Services INC
Organization subpart
No
Enumeration date
Jun 19, 2023
Certification date
Jun 20, 2023
Last updated
Jun 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental Health––Yes

Practice location

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344

Phone 301-576-3515

Mailing address

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344

Phone 301-576-3515

Authorized official

Siphra Ngum Mukoro
NP
3016753515

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