Individual
KONTIA JONTAE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
123 HENDERSONVILLE RD, ASHEVILLE, NC 28803-2868
(828) 257-4730
(828) 232-2942
Mailing address
15 ROE RD, GREENVILLE, SC 29611-7423
(864) 295-2308
(864) 295-2635
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
20719
SC
363LF0000X
Family Nurse Practitioner
Primary
5008188
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093189011
—
NC
Enumeration date
11/16/2015
Last updated
05/09/2024
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