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Organization
GRACE CARE MEDICAL LLC
Active
Organization
GRACE CARE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER NICOLE MOULTRIE APRN (APRN)
(850) 712-5877
Entity
Organization
Contact information
Practice address
4929 MOBILE HWY, PENSACOLA, FL 32506-3229
(850) 960-7971
Mailing address
4929 MOBILE HWY, PENSACOLA, FL 32506-3229
(850) 960-7971
(850) 961-0011
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
11/19/2024
Last updated
12/02/2025
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