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Organization
GRACE INTEGRATED HEALTH & WELLNESS, LLC
Active
Organization
GRACE INTEGRATED HEALTH & WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RETTIG NURSE PRACTITIONER (CEO)
(903) 705-8509
Entity
Organization
Contact information
Practice address
1000 SOUTH BECKHAM, TYLER, TX 75701
(903) 284-5158
Mailing address
PO BOX 9995, TYLER, TX 75711-2995
(903) 705-8509
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
—
—
363LC1500X
Community Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NPI1265977144
—
TX
Enumeration date
07/07/2020
Last updated
07/07/2020
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