Individual
CARON C GRANT-ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
554 S BELLVIEW, MESA, AZ 85204-2504
(480) 649-1141
Mailing address
3691 W YELLOW PEAK DR, QUEEN CREEK, AZ 85242-3076
(480) 677-4160
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN133597
AZ
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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