Individual
MRS. GRACE E CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
134 BUSINESS PARK DR, VIRGINIA BEACH, VA 23462-6523
(757) 473-0055
Mailing address
536 NEW JERSEY AVE, NORFOLK, VA 23508-2719
(757) 963-0760
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024167075
VA
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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