Individual
DESIREA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2000 W. VENANGO STREET, PHILA, PA 19140
(267) 281-4956
Mailing address
816 CHRISTIAN STREET, GLASSBORO, NJ 08028
(215) 881-3298
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN592036
PA
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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