Provider Demographics
NPI:1538776281
Name:GRANTIER, GRACE ECKFORD (CRNP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ECKFORD
Last Name:GRANTIER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ANN
Other - Last Name:ECKFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2511 ALTADENA FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4618
Mailing Address - Country:US
Mailing Address - Phone:601-408-1009
Mailing Address - Fax:
Practice Address - Street 1:2700 HIGHWAY 280 S STE 212
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2468
Practice Address - Country:US
Practice Address - Phone:205-878-4368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-180989363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily