Individual
DR. LYNTRESSA DANIELLE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
111 SW 5TH AVE, PORTLAND, OR 97204-3604
(866) 277-9071
Mailing address
11100 SW 93RD COURT RD, SUITE 10-BOX 118, OCALA, FL 34481
(833) 437-5433
(833) 999-0975
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
201509160NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP5646
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APN24094
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9236028
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009044300
—
FL
05
—
030323
—
AZ
05
—
DMAP500698768
—
OR
Enumeration date
03/05/2013
Last updated
03/26/2024
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