MEDICARE: MS. GRACE COX APPLEWHITE FNP-C

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	363LF0000X	Family Nurse Practitioner	805476	MS

General Provider Information

NPI Number	:	1740649896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GRACE COX APPLEWHITE FNP-C

Provider Business Mailing Address
First Line	:	403 KNIGHTS CV W
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39047-4444
Country	:	US
Telephone Number	:	601-540-7042
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 HIGHWAY 49 S STE 1
Second Line	:
City	:	RICHLAND
State	:	MS
Zip	:	39218-9438
Country	:	US
Telephone Number	:	601-973-1576
Fax Number	:	601-664-0055

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

Provider Enumeration Date	:	02/17/2016
Last Update Date	:	10/15/2021

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