Individual
GRACE NYATENYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
4922 SPRING AVE, DALLAS, TX 75210-1359
(214) 421-7848
Mailing address
4922 SPRING AVE, DALLAS, TX 75210-1359
(214) 421-7848
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
AP133703
TX
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
AP133703
TX
Other
Enumeration date
05/05/2017
Last updated
01/22/2021
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