Healthcare Provider Details

I. General information

NPI: 1528618899
Provider Name (Legal Business Name): GRACE KIMBLE MCALPIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE CAROLINE KIMBLE

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 JOHNSON FY RD NE
ATLANTA GA
30342-1605
US

IV. Provider business mailing address

144 HUNTINGTON RD NE
ATLANTA GA
30309-1504
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-5437
  • Fax:
Mailing address:
  • Phone: 713-298-5732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberRN239935
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: