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Organization

GRACE HEALTHCARE SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SIPHRA NGUM MUKORO PMHNP (NP)
(301) 675-3515
Entity
Organization

Contact information

Practice address
5100 BUCKEYSTOWN PIKE STE 250, FREDERICK, MD 21704-8344
(301) 576-3515
Mailing address
5100 BUCKEYSTOWN PIKE STE 250, FREDERICK, MD 21704-8344
(301) 576-3515

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
06/19/2023
Last updated
06/20/2023
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