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Individual
MS. TINA M. GRALL
Active
Individual
MS. TINA M. GRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN060199
GA
363LF0000X
Family Nurse Practitioner
RN060199
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003185368A
—
GA
05
—
003185368B
—
GA
01
—
202I504936
MEDICARE PTAN
GA
Enumeration date
01/20/2017
Last updated
09/01/2020
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