Provider Demographics
NPI:1528829082
Name:ALFORD, GRACE ELIZABETH
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ELIZABETH
Last Name:ALFORD
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 1:110 POLARIS PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8074
Mailing Address - Country:US
Mailing Address - Phone:614-865-4800
Mailing Address - Fax:614-865-4900
Practice Address - Street 1:110 POLARIS PKWY STE 250
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8074
Practice Address - Country:US
Practice Address - Phone:614-865-4800
Practice Address - Fax:614-865-4900
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF07230534363LF0000X
OHAPRN.CNP.0035731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily