Individual
LAURA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 1ST CAPITOL DR STE 401, SAINT CHARLES, MO 63301-2886
(636) 669-2220
Mailing address
11125 DUNN RD STE 204, SAINT LOUIS, MO 63136-6188
(314) 839-5125
(314) 839-5351
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2017022707
MO
Other
Enumeration date
08/14/2017
Last updated
07/21/2022
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