Individual
GRETCHEN JANINIA KRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.A-C
Contact information
Practice address
724 AUBREY BELL DRIVE, MATTHEWS, NC 28105-5055
(704) 295-3550
(704) 295-3556
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03037
NC
363AM0700X
Medical Physician Assistant
MA051978
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1298PA
—
SC
01
—
1679J
BCBSNC
NC
05
—
8102326
—
NC
01
—
9965514
AETNA
—
01
—
P01103054
RAILROAD MEDICARE
NC
Enumeration date
07/20/2006
Last updated
01/31/2013
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