NPIMap

Organization Active NPI

Grace Provider Services

  • Family Nurse Practitioner
  • Kentwood, LA
National Provider Identifier
1124949342
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GRACE PROVIDER SERVICES
Practice address
365 Tiger Bend Rd
Kentwood, LA 70444-8131
Phone
(601) 310-9340
NPI assigned
Jul 23, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Michelle Hasty, NPNPI 1497426548
Title
Nurse Practitioner
Phone
(601) 310-9340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

365 Tiger Bend Rd
Kentwood, LA 70444-8131

Mailing address

365 Tiger Bend Rd
Kentwood, LA 70444-8131
Phone (601) 310-9340

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1124949342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 TIGER BEND RD",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "704448131",
            "telephone_number": "601-310-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 TIGER BEND RD",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "704448131",
            "telephone_number": "601-310-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE PROVIDER SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "HASTY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-310-9340",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.