Provider Demographics
NPI:1447749528
Name:MUELLER, GRACE (CPM)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PERSIMMON PEAR LN
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-6130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 PERSIMMON PEAR LN
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-6130
Practice Address - Country:US
Practice Address - Phone:304-279-0396
Practice Address - Fax:844-286-3399
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDEM00016176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife