Provider Demographics
NPI:1750815429
Name:ST. PIERRE, GRACE (FNP-C)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:ST. PIERRE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:149 GREAT COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03603-4164
Mailing Address - Country:US
Mailing Address - Phone:603-558-0278
Mailing Address - Fax:
Practice Address - Street 1:17068 LANKFORD HIGHWAY
Practice Address - Street 2:
Practice Address - City:EASTVILLE
Practice Address - State:VA
Practice Address - Zip Code:23347
Practice Address - Country:US
Practice Address - Phone:757-331-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH060930-23363LF0000X
VA0024184094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily