National Provider Identifier

Jaclyn M Grace

Jaclyn M Grace is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Niagara Falls, NY and a listed phone number of (716) 622-3130.

NPI 1629717715Niagara Falls, NYFamily Nurse Practitioner

Profile Overview

NPI
1629717715
Provider Type
Individual
Primary Specialty
Family Nurse Practitioner
Enumeration Date
May 27, 2022
Last Updated
May 27, 2022

Practice Location

  • 1323 104Th St
  • Niagara Falls, NY 14304-2923

Phone: (716) 622-3130

Specialties

  • Family Nurse Practitioner (363LF0000X)
Full Record
NPI
1629717715
Entity Type
Individual
Last Name
Grace
First Name
Jaclyn
Middle Name
M
Mailing Street Address
1323 104Th St
Mailing City
Niagara Falls
Mailing State
NY
Mailing ZIP Code
14304-2923
Mailing Country
US
Practice Street Address
1323 104Th St
Practice City
Niagara Falls
Practice State
NY
Practice ZIP Code
14304-2923
Practice Country
US
Practice Phone
(716) 622-3130
Enumeration Date
May 27, 2022
Last Updated
May 27, 2022
Sex
Female
Sole Proprietor
No
Certification Date
May 27, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Nurse Practitioner (363LF0000X)