Individual
CODY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(859) 323-5000
Mailing address
333 SQUIRES RD, LEXINGTON, KY 40515-5620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3013064
KY
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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