Elmore, Grady

Elmore, Grady is an individual health care provider with primary practice located at 120 Trinity Pl , Athens GA 30607-2100. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Elmore, Grady can be contacted via phone (706) 543-2718.

Contact Information

Primary practice address
120 Trinity Pl Athens GA 30607-2100
Phone: (706) 543-2718
Fax: (706) 353-3709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN129091NP Georgia

Profile Details

NPI number 1205834009
LBN Legal business name Elmore, Grady
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205834009 NPPES
Georgia MEDICAID 00887136A

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