Provider Demographics
NPI:1386454296
Name:LYNCH, GRACE
Entity type:Individual
Prefix:MISS
First Name:GRACE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7915 M 55
Mailing Address - Street 2:
Mailing Address - City:WHITTEMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48770-9749
Mailing Address - Country:US
Mailing Address - Phone:989-324-2131
Mailing Address - Fax:
Practice Address - Street 1:7915 M 55
Practice Address - Street 2:
Practice Address - City:WHITTEMORE
Practice Address - State:MI
Practice Address - Zip Code:48770-9749
Practice Address - Country:US
Practice Address - Phone:989-324-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care