Individual
MRS. NANCY M GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
36 WALLER ST, SCHOOL BASED HEALTH CENTER BDJM, NEW LONDON, CT 06320
(860) 701-3772
(860) 701-3772
Mailing address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
000836
CT
364SP0200X
Pediatric Clinical Nurse Specialist
000836
CT
Other
Enumeration date
07/31/2006
Last updated
02/16/2012
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