| Grace Vision, Inc. | |
|
3001 White Bear Ave N, Suite 1050, Saint Paul, MN 55109-1215 | |
| (651) 770-3924 | |
| Not Available |
| Full Name | Grace Vision, Inc. |
|---|---|
| Type | Facility |
| Speciality | Technician/technologist - Optician |
| Location | 3001 White Bear Ave N, Saint Paul, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386077592 | NPI | - | NPPES |
| 1073609715 | Other | MN | NPI |
| 1386077592 | Other | MN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 156FX1800X | Technician/technologist - Optician | 2339 (Minnesota) | Primary |
| Provider Name | Jeanny M Liu-wu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073609715 PECOS PAC ID: 3971630633 Enrollment ID: I20100428000972 |
| Provider Name | Gaile Kristine Philipp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740515832 PECOS PAC ID: 6709187180 Enrollment ID: I20151209002429 |
| Provider Name | Nathan Haverkamp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669967188 PECOS PAC ID: 1658622642 Enrollment ID: I20181002001456 |
| Provider Name | Derek You-chun Wu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265207716 PECOS PAC ID: 6103279104 Enrollment ID: I20240125003536 |
| Provider Name | Sarah Grace Watson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396504304 PECOS PAC ID: 8426499831 Enrollment ID: I20240516002114 |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Vision, Inc. 3781 Fairway Dr, Woodbury, MN 55125-5019 Ph: (651) 735-3477 | Grace Vision, Inc. 3001 White Bear Ave N, Suite 1050, Saint Paul, MN 55109-1215 Ph: (651) 770-3924 |