Individual
GRACE CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 CALLEN BLVD, SUMMERVILLE, SC 29486-2807
(843) 572-3330
Mailing address
9150 MEDCOM ST STE B, NORTH CHARLESTON, SC 29406-9196
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
27628
SC
Other
Enumeration date
01/10/2023
Last updated
09/19/2024
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