Provider Demographics
NPI:1528253747
Name:GRAU, GRACE (CRNP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:GRAU
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:GRAU
Other - Last Name:VACHERESSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:2700 10TH AVE S
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1200
Mailing Address - Country:US
Mailing Address - Phone:205-939-0139
Mailing Address - Fax:205-939-4997
Practice Address - Street 1:2700 10TH AVE S
Practice Address - Street 2:SUITE 305
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1200
Practice Address - Country:US
Practice Address - Phone:205-939-0139
Practice Address - Fax:205-939-4997
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-096670363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51543152OtherBCBS OF ALABAMA