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Individual
MS. GRACIE MAE ADKISSON
Active
Individual
MS. GRACIE MAE ADKISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024177015
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP126190
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP4254
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP126190
STATE LICENSE NUMBER
TX
Enumeration date
11/08/2011
Last updated
05/24/2023
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