Individual
MS. MARY GRACE EVASCO VINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
302 E JAMES LEE BLVD, CRESTVIEW, FL 32539-2827
(302) 325-3928
Mailing address
302 E JAMES LEE BLVD, CRESTVIEW, FL 32539-2827
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11026114
FL
363LA2100X
Acute Care Nurse Practitioner
ARNP11026114
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP11026114
FL
363LC1500X
Community Health Nurse Practitioner
ARNP11026114
FL
363LF0000X
Family Nurse Practitioner
ARNP11026114
FL
Other
Enumeration date
05/02/2023
Last updated
09/23/2025
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