Provider Demographics
NPI:1821670456
Name:GRACE, JOSEPH LAMAR JR (CRNP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LAMAR
Last Name:GRACE
Suffix:JR
Gender:M
Credentials:CRNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:953 JEFF RD NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-1237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:953 JEFF RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1237
Practice Address - Country:US
Practice Address - Phone:256-322-6272
Practice Address - Fax:256-322-4987
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-155558363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health