Individual
AUDREY NADINE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
5255 LOUGHBORO RD NW, WASHINGTON, DC 20016-2633
(202) 537-4122
Mailing address
1332 INGRAHAM ST NW, WASHINGTON, DC 20011-3604
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA47
DC
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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