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General NPI Number Information
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NPI Number | 1013707280
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Entity Type | Organization
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Legal Business Name | NATURE'S GRACE PRECISION HEALTH
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 804 S MAIN ST
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City | GRACE
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State | ID
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Zip | 83241-4712
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Country | US
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Telephone | 208-220-7111
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Fax | 208-269-1491
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Provider Business Mailing Address
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Address Line | 804 S MAIN ST
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City | GRACE
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State | ID
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Zip | 83241-4712
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Country | US
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Telephone | 208-220-7111
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Fax | 208-269-1491
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Authorized Official
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Title or Position | OWNER
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Name | PATTY ACKERMAN
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Credential | DNP, APRN
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Telephone | 208-220-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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