Individual
MS. CAROLYN M GRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
51 N DUNLAP ST, MEMPHIS, TN 38105-4625
(901) 287-7337
(901) 387-5151
Mailing address
850 POPLAR AVE BLDG 2, MEMPHIS, TN 38105-4607
(901) 287-7337
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
ARNP9206478
FL
363L00000X
Nurse Practitioner
ARNP9206478
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
28797
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018868100
—
FL
05
—
Q064647
—
TN
Enumeration date
02/16/2006
Last updated
04/07/2021
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