Individual
KENYA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9600 DROMORE CT, SAINT LOUIS, MO 63136-3002
(314) 315-0934
Mailing address
9600 DROMORE CT, SAINT LOUIS, MO 63136-3002
(314) 315-0934
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2019045321
MO
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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