Provider Demographics
NPI:1225718976
Name:ROYLE, GRACE ANNE (PA)
Entity Type:Individual
Prefix:MISS
First Name:GRACE
Middle Name:ANNE
Last Name:ROYLE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13609 E PAWNEE RD UNIT 33
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-9120
Mailing Address - Country:US
Mailing Address - Phone:620-253-4948
Mailing Address - Fax:
Practice Address - Street 1:13609 E PAWNEE RD UNIT 33
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-9120
Practice Address - Country:US
Practice Address - Phone:620-253-4948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program