MEDICARE: MS. GRADIA CAROLYN JUNIUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	95036688	CA

General Provider Information

NPI Number	:	1366301558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GRADIA CAROLYN JUNIUS

Provider Business Mailing Address
First Line	:	920 HARBOR BEND RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38103-0816
Country	:	US
Telephone Number	:	240-620-3819
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 HARBOR BEND RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38103-0816
Country	:	US
Telephone Number	:	240-620-3819
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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