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General NPI Number Information
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NPI Number | 1225554355
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Entity Type | Organization
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Legal Business Name | GRACE INTEGRATIVE HEALTHCARE, LLC
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1623 YORK AVE STE 103
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City | HIGH POINT
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State | NC
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Zip | 27265-2355
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Country | US
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Telephone | 336-715-0007
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Fax | 336-915-2405
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Provider Business Mailing Address
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Address Line | 1623 YORK AVE STE 103
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City | HIGH POINT
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State | NC
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Zip | 27265-2355
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Country | US
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Telephone | 336-715-0007
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Fax | 336-915-2405
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Authorized Official
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Title or Position | CFO
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Name | AMY R WEBB
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Credential |
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Telephone | 336-715-0007
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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 | 5008698
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5008698
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 5008698
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5008698
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License Number State | NC
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