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Individual

GRACE MARIE IRISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-2000
Mailing address
14301 MARTIN DR APT 308, EDEN PRAIRIE, MN 55344-3008
(701) 566-3001

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5386
MN
363LA2200X
Adult Health Nurse Practitioner
5386
MN
363LG0600X
Gerontology Nurse Practitioner
5386
MN

Other

Enumeration date
09/21/2017
Last updated
01/09/2024
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