Individual
MS. SALLY L GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.N.
Contact information
Practice address
614 E EMMA AVE, SUITE 300, SPRINGDALE, AR 72764-4634
(479) 751-7417
(479) 751-4898
Mailing address
614 E EMMA AVE, SUITE 300, SPRINGDALE, AR 72764-4634
(479) 751-7417
(479) 751-4898
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
A01038
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190222758
—
AR
01
—
A01038
STATE LICENSE
AR
Enumeration date
02/17/2006
Last updated
08/27/2013
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