Individual
MRS. MICHELLE ROSALIE GRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
528 N MAIN ST UNIT 4, PROVIDENCE, RI 02904-5770
(401) 276-4020
Mailing address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
(401) 276-4020
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-07837
NC
363A00000X
Physician Assistant
Primary
PA01410
RI
363A00000X
Physician Assistant
PA9107804
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010608300
—
FL
Enumeration date
02/14/2014
Last updated
08/02/2023
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