Individual
DR. AMY NICOLE GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4720 S I-10 SERVICE RD, STE 502, METAIRIE, LA 70001
(504) 885-6060
(504) 887-2114
Mailing address
4720 S I-10 SERVICE RD, STE 502, METAIRIE, LA 70001
(504) 885-6060
(504) 887-2114
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
25113
AL
207V00000X
Obstetrics & Gynecology Physician
Primary
MD200156
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1626775
—
LA
01
—
200156
STATE
LA
01
—
32593
CDS
LA
01
—
P00459229
RAILROAD MEDICARE
LA
Enumeration date
09/27/2006
Last updated
03/07/2023
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