Provider Demographics
NPI:1023984614
Name:SHARPLESS, GRACE TERESE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:TERESE
Last Name:SHARPLESS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 N DODGE ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-6102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:833-719-1241
Practice Address - Street 1:1125 N DODGE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-6102
Practice Address - Country:US
Practice Address - Phone:319-354-9223
Practice Address - Fax:833-719-1241
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA135053133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered