Healthcare Provider Details

I. General information

NPI: 1558276428
Provider Name (Legal Business Name): GRACE MEYERS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 S 6TH ST
MINNEAPOLIS MN
55454-1336
US

IV. Provider business mailing address

2312 S 6TH ST
MINNEAPOLIS MN
55454-1336
US

V. Phone/Fax

Practice location:
  • Phone: 763-210-4676
  • Fax:
Mailing address:
  • Phone: 712-790-6388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number32372
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: