Provider Demographics
NPI:1235499302
Name:FOX, GRACE MARIE
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:MARIE
Last Name:FOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4649 COAL BANK DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6542
Mailing Address - Country:US
Mailing Address - Phone:541-621-3984
Mailing Address - Fax:
Practice Address - Street 1:4649 COAL BANK DR
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6542
Practice Address - Country:US
Practice Address - Phone:541-621-3984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No176B00000XOther Service ProvidersMidwife