Grace, Sally L

Grace, Sally L is an individual health care provider with primary practice located at 614 E Emma Ave Suite 300, Springdale AR 72764-4634. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Grace, Sally L can be contacted via phone (479) 751-7417.

Contact Information

Primary practice address
614 E Emma Ave Suite 300 Springdale AR 72764-4634
Phone: (479) 751-7417
Fax: (479) 751-4898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X A01038 Arkansas

Profile Details

NPI number 1568437135
LBN Legal business name Grace, Sally L
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Aug 27th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568437135 NPPES
Arkansas MEDICAID 190222758
Arkansas Other A01038

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