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MR. JOHN R GRANDGENETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
3100 N 14TH ST STE 201, LINCOLN, NE 68521-2134
(402) 476-1455
(402) 476-1670
Mailing address
1021 N 27TH ST, LINCOLN, NE 68503-1803
(402) 476-1455
(402) 476-1670

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
110342
NE
363LF0000X
Family Nurse Practitioner
Primary
110342
NE

Other

Enumeration date
07/28/2006
Last updated
01/15/2025
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