Individual
GRACE N/A NUM-BOATEMAA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1545 PULASKI HWY, BEAR, DE 19701-1303
(302) 544-1395
(302) 544-1395
Mailing address
20212 CHAMPION FOREST DR STE 100, SPRING, TX 77379-8781
(346) 478-6611
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1172140
TX
363LF0000X
Family Nurse Practitioner
LG-0012566
DE
Other
Enumeration date
11/14/2023
Last updated
04/03/2025
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