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Individual
GRANT FABRY
Active
Individual
GRANT FABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
114889
NE
363LG0600X
Gerontology Nurse Practitioner
114889
NE
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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