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Individual
STACY GRACE
Active
Individual
STACY GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NO08583700
NJ
363L00000X
Nurse Practitioner
Primary
26NN08583700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8448604
—
NJ
Enumeration date
01/07/2011
Last updated
01/18/2012
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