Individual
GRACE GLEASON
Active
Individual
GRACE GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
822282
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041346210
NURSE REGISTERED PROFESSIONAL
IL
01
—
1982991576
TRICARE STANDARD
IL
01
—
209008861
CERTIFIED NURSE PRACITIONER
IL
Enumeration date
07/01/2011
Last updated
10/04/2019
Update your record
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