Provider Demographics
NPI:1962855981
Name:GRACE CARE
Entity Type:Organization
Organization Name:GRACE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:931-743-1955
Mailing Address - Street 1:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37357-0132
Mailing Address - Country:US
Mailing Address - Phone:931-743-1955
Mailing Address - Fax:
Practice Address - Street 1:2981 HICKORY GROVE RD
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:TN
Practice Address - Zip Code:37357-3442
Practice Address - Country:US
Practice Address - Phone:931-743-1955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN8080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty