Individual
GRACE EVELYN COLLUPY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
719 RODEL CV, LAKE MARY, FL 32746-5716
(407) 262-5710
Mailing address
719 RODEL CV, LAKE MARY, FL 32746-5716
(407) 262-5710
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
9244471
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308599600
—
FL
Enumeration date
08/23/2007
Last updated
01/20/2016
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