Provider Demographics
NPI:1649491218
Name:GRADNEY, EDDIE M (APRN)
Entity type:Individual
Prefix:MRS
First Name:EDDIE
Middle Name:M
Last Name:GRADNEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21107 SOMERVELL CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-7167
Mailing Address - Country:US
Mailing Address - Phone:281-298-6654
Mailing Address - Fax:281-238-0201
Practice Address - Street 1:21107 SOMERVELL CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7167
Practice Address - Country:US
Practice Address - Phone:281-298-6654
Practice Address - Fax:281-238-0201
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP114826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily