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Organization
GRACE MEDICAL LLC
Active
Organization
GRACE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKSHIRA MARIE MOSELY APRN (OWNER)
(504) 376-4017
Entity
Organization
Contact information
Practice address
5444 ELYSIAN FIELDS AVE, NEW ORLEANS, LA 70122-4222
(504) 539-8364
(504) 226-0892
Mailing address
5444 ELYSIAN FIELDS AVE, NEW ORLEANS, LA 70122-4222
(504) 376-4017
(504) 226-0892
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/17/2021
Last updated
10/25/2025
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