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General NPI Number Information
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NPI Number | 1952127144
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Entity Type | Organization
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Legal Business Name | GRACE WELLNESS LLC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 1301 7TH ST
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City | BEDFORD
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State | IN
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Zip | 47421-2141
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Country | US
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Telephone | 812-583-2561
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1169
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City | BEDFORD
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State | IN
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Zip | 47421-1169
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/FAMILY PRACTITIONER
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Name | AMANDA NAPIER
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Credential | FNP-C
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Telephone | 812-583-2561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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