Individual
DR. KATHLEEN MARY GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4101 WOOLWORTH AVE, 11TH FLOOR SUDP, OMAHA, NE 68105-1850
(402) 449-0679
(402) 977-5684
Mailing address
4101 WOOLWORTH AVE, 11TH FLOOR SUDP, OMAHA, NE 68105-1850
(402) 449-0679
(402) 977-5684
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
18660
NE
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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