Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grace Family Practice Clinic, PC

Organization Family Medicine Physician · NPI 1083124671

Grace Family Practice Clinic, PC provides Family Medicine Physician services in Dyersburg, Tennessee. Licensed in Tennessee. Registered with an NPI since 2017.

Licensed in
TN
In the registry since
2017
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1716 Parr Ave Ste D
Dyersburg, TN 38024-2074
Phone: (731) 288-0911
Fax: (731) 288-0065
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Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD35727 (TN)
Family Medicine Physician Taxonomy 207Q00000X · Licence MD25289 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence APN13637 (TN)

Record details

NPI number1083124671
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Monique Casey-Bolden — President · (731) 288-0911
NPI enumeratedOctober 9, 2017
Last updated in NPPESOctober 9, 2017
Mailing address1716 Parr Ave Ste D, Dyersburg, TN 38024-2074

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