Healthcare Provider Details

I. General information

NPI: 1487565990
Provider Name (Legal Business Name): GRACE GUURU PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 HAMILTOWNE CIR
BALTIMORE MD
21237-1433
US

IV. Provider business mailing address

2312 HAMILTOWNE CIR
BALTIMORE MD
21237-1433
US

V. Phone/Fax

Practice location:
  • Phone: 410-241-8878
  • Fax:
Mailing address:
  • Phone: 410-241-8878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberR212547
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: