Sally L Grace, A.P.N.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

A01038 Issued in AR

Practice address

614 E Emma Ave
Suite 300
Springdale, AR 72764-4634

Phone

(479) 751-7417

Fax

(479) 751-4898

NPI assigned

Feb 17, 2006

Last updated

Aug 27, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PLW Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Oklahoma City, OK
  • NPI 1700040680
  NPD (past)

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1568437135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E EMMA AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644634",
            "telephone_number": "479-751-7417",
            "fax_number": "479-751-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E EMMA AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644634",
            "telephone_number": "479-751-7417",
            "fax_number": "479-751-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "SALLY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AR",
            "license": "A01038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A01038",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190222758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bailey Gould
• Staci Marie Graber, APN
• Grace Family Medical, LLC (Rehydration Station and Aesthetics)
• Grace Haven Ministries
• Maria T Grace, LCSW
• Caisa Gracie, LMSW
• Alicia Leah Graham, MHPP
• Alyson Jade Graham
• Keisha Graham
• Tatum Rose Graham

• Women's Health Nurse Practitioner in Springdale, AR
• Providers in Springdale, AR by specialty
• Women's Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.