Organization
GRACE PROVIDER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MICHELLE HASTY NP (NURSE PRACTITIONER)
(601) 310-9340
Entity
Organization
Contact information
Practice address
365 TIGER BEND RD, KENTWOOD, LA 70444-8131
(601) 310-9340
Mailing address
365 TIGER BEND RD, KENTWOOD, LA 70444-8131
(601) 310-9340
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/23/2026
Last updated
07/23/2026
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