Provider Demographics
NPI:1902478340
Name:GRIT & GRACE PLLC
Entity Type:Organization
Organization Name:GRIT & GRACE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:GEARHART
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:406-471-6419
Mailing Address - Street 1:3950 VALLEY COMMONS DR STE 2
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-5662
Mailing Address - Country:US
Mailing Address - Phone:406-471-6419
Mailing Address - Fax:
Practice Address - Street 1:3950 VALLEY COMMONS DR STE 2
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5662
Practice Address - Country:US
Practice Address - Phone:406-471-6419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty