Individual
GRACE MAINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 HIDDEN RDG APT 2005, IRVING, TX 75038-7973
(469) 226-1159
Mailing address
1104 HIDDEN RDG APT 2005, IRVING, TX 75038-7973
(469) 226-1159
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
126399
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
126399
TX
Other
Enumeration date
08/27/2014
Last updated
10/26/2014
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