Individual
GRACE ANNE GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
705 RILEY HOSPITAL DR, ROC 4270, INDIANAPOLIS, IN 46202-5109
(317) 274-7208
(317) 274-7227
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28193477
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71006402
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201389260
—
IN
Enumeration date
06/19/2016
Last updated
01/19/2021
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