Organization
BLURRED GRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER WOODS NP (OWNER)
(601) 248-1218
Entity
Organization
Contact information
Practice address
921 AVENUE G, KENTWOOD, LA 70444-2639
(985) 229-0717
Mailing address
1054 HAWTHORNE DR, MCCOMB, MS 39648-9551
(601) 248-1218
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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