Individual
GRACE TERABERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2043 N 64TH DR, PHOENIX, AZ 85035-3424
(623) 691-5515
Mailing address
2043 N 64TH DR, PHOENIX, AZ 85035-3424
(623) 691-5515
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
282451
AZ
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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