Individual
GRACE K. GRAJALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
305 FLANDERS RD, EAST LYME, CT 06333-1743
(860) 739-0348
(860) 739-6779
Mailing address
305 FLANDERS RD, EAST LYME, CT 06333-1743
(860) 739-0348
(860) 739-6779
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4274
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008039710
—
CT
05
—
008072609
—
CT
Enumeration date
12/19/2006
Last updated
07/21/2022
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