Individual
MARY JO GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 MARIO CAPECCHI DR, SLC, UT 84113-1103
(801) 662-2442
Mailing address
100 MARIO CAPECCHI DR, SLC, UT 84113-1103
(801) 662-2442
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
218983-4405
UT
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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