Individual
SAMANTHA NICOLE GRANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
87-136 KULALA PL, WAIANAE, HI 96792-3364
(760) 646-6006
Mailing address
87-136 KULALA PL, WAIANAE, HI 96792-3364
(760) 646-6006
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
252862
CA
Other
Enumeration date
11/19/2014
Last updated
11/19/2014
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