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General NPI Number Information
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NPI Number | 1053956060
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Entity Type | Organization
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Legal Business Name | GRACE MEDICAL, PLLC
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 120 OLD VIRGINIA AVE
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City | RICH CREEK
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State | VA
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Zip | 24147-9669
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Country | US
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Telephone | 540-250-3778
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Fax |
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Provider Business Mailing Address
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Address Line | 895 W SPILLER ST
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City | WYTHEVILLE
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State | VA
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Zip | 24382-1725
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Country | US
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Telephone | 540-250-3778
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Fax | 540-944-4002
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Authorized Official
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Title or Position | FNP/OWNER
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Name | RAMONA BOYER
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Credential | MSN, APRN, FNP-BC
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Telephone | 540-250-3778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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