Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GRACE EDITH LINE
ActiveGRACE EDITH LINE is a Driver healthcare provider located in ANDOVER, Minnesota. NPI 1790318186 is currently active in the NPPES registry. Verify at CMS.
Driver · ANDOVER, MN
Registration Details
- NPI Number
- 1790318186
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 13, 2020 (6.5086638984417 yrs)
- Last Updated
- Feb 13, 2020
- License
-
B772-020-465-216 (MN)
Practice Information
- Address
-
2934 168TH LN NWANDOVER, MN, 553041928Browse MN providers · Browse ZIP 55304
- Phone
- 2184815357
- Primary Specialty
-
Driver
172A00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.