Individual
COLIN GRANDGENETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3100 N 14TH ST, LINCOLN, NE 68521-2134
(402) 477-6600
Mailing address
649 COUNTY ROAD 14, WAHOO, NE 68066-4034
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/13/2025
Last updated
07/31/2025
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