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General NPI Number Information
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NPI Number | 1619744398
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Entity Type | Organization
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Legal Business Name | GRACE MEDICAL OF AIKEN LLC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 415 BARNWELL AVE NW
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City | AIKEN
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State | SC
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Zip | 29801-3937
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Country | US
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Telephone | 803-226-0274
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Fax | 803-226-0436
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Provider Business Mailing Address
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Address Line | PO BOX 537
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City | AIKEN
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State | SC
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Zip | 29802-0537
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Country | US
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Telephone | 803-226-0274
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Fax | 803-226-0436
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Authorized Official
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Title or Position | OWNER
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Name | ANNA ALLMAN
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Credential | NP
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Telephone | 803-270-1101
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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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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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