MEDICARE: GRACE CARR LPN, CPRS

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	175T00000X	Peer Specialist	APS.007121	OH
2	164W00000X	Licensed Practical Nurse	LPN146737	OH

General Provider Information

NPI Number	:	1992227557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE CARR LPN, CPRS

Provider Business Mailing Address
First Line	:	150 S B ST APT 306
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-3357
Country	:	US
Telephone Number	:	513-596-5909
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 S B ST APT 306
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-3357
Country	:	US
Telephone Number	:	513-596-5909
Fax Number	:

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

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	01/28/2026

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