Provider Demographics
NPI:1962199265
Name:GRACE 4 WOMEN, LLC
Entity type:Organization
Organization Name:GRACE 4 WOMEN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:318-801-8868
Mailing Address - Street 1:902 ADCOCK RD
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-6446
Mailing Address - Country:US
Mailing Address - Phone:318-801-8868
Mailing Address - Fax:
Practice Address - Street 1:1205 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5603
Practice Address - Country:US
Practice Address - Phone:318-654-4075
Practice Address - Fax:318-232-5463
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRACE 4 WOMEN, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty