Individual
KIMBERLY ANN GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 FAIRMOUNT AVE, FORT WORTH, TX 76104-4215
(817) 263-5864
(817) 338-0927
Mailing address
1201 FAIRMOUNT AVE, FORT WORTH, TX 76104-4215
(817) 335-5288
(817) 338-0927
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1126444
TX
363LA2100X
Acute Care Nurse Practitioner
1126444
TX
Other
Enumeration date
06/27/2023
Last updated
01/12/2024
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