Individual
SOMMER J GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
146 W DALE ST, SUITE 201, WATERLOO, IA 50703-1901
(319) 234-4431
(319) 235-5004
Mailing address
146 W DALE ST, SUITE 201, WATERLOO, IA 50703-1901
(319) 234-4431
(319) 235-5004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
105635
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00751284
RR MEDICARE
IA
Enumeration date
12/30/2005
Last updated
10/20/2009
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