Organization
BY HIS GRACE PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA PICKETT CRNP (CRNO, CEO)
(334) 806-9233
Entity
Organization
Contact information
Practice address
806 GLOVER AVE STE A, ENTERPRISE, AL 36330-2018
(334) 475-2680
(334) 475-2681
Mailing address
806 GLOVER AVE STE A, ENTERPRISE, AL 36330-2018
(334) 475-2680
(334) 475-2681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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