Provider Demographics
NPI:1295515112
Name:GRACE PSYCHIATRIC SERVICES, PLLC
Entity type:Organization
Organization Name:GRACE PSYCHIATRIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSN, APRN, PMHNP-BC AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KERBY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHNP-BC
Authorized Official - Phone:512-868-3972
Mailing Address - Street 1:2913 WILLIAMS DR STE 220
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2739
Mailing Address - Country:US
Mailing Address - Phone:512-868-3972
Mailing Address - Fax:
Practice Address - Street 1:2913 WILLIAMS DR STE 220
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2739
Practice Address - Country:US
Practice Address - Phone:512-868-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty