Individual
MS. MARY ELIZABETH GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
1120 63RD ST S, GULFPORT, FL 33707-3125
(727) 347-2914
(727) 895-7225
Mailing address
1120 63RD ST S, GULFPORT, FL 33707-3125
(727) 347-2914
(727) 895-7225
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
ARNP 1572502
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
019367
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP 1572502
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300887800
—
FL
05
—
764196600
—
FL
Enumeration date
05/05/2007
Last updated
04/02/2018
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