| Gracious Health Services | |
|
1035 Marshane Rd Reisterstown MD 21136-5861 | |
| (443) 850-5679 | |
| Not Available |
| Full Name | Gracious Health Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1035 Marshane Rd, Reisterstown, Maryland |
| Authorized Official Name and Position | Diana Pieterson (OWNER) |
| Authorized Official Contact | 4438505679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gracious Health Services 1035 Marshane Rd Reisterstown MD 21136-5861 Ph: (443) 850-5679 | Gracious Health Services 1035 Marshane Rd Reisterstown MD 21136-5861 Ph: (443) 850-5679 |
| NPI Number | 1730848227 |
|---|---|
| Provider Enumeration Date | 12/11/2021 |
| Last Update Date | 12/11/2021 |
| Certification Date | 12/11/2021 |
| Medicare PECOS PAC ID | 1052706900 |
|---|---|
| Medicare Enrollment ID | O20220311001648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730848227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Diana Pieterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558930073 PECOS PAC ID: 5698173243 Enrollment ID: I20211012001475 |
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