Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
SALLY MALONEY GRACE
Active
Individual
SALLY MALONEY GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1025132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309118000
MEDICAID
FL
01
—
Y124G
BLUE SHIELD
FL
Enumeration date
03/26/2008
Last updated
10/20/2014
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