Individual
KELLY NAGEL GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
19176 HALL RD, CLINTON TOWNSHIP, MI 48038
(800) 379-1600
Mailing address
915 VERNIER RD, GROSSE POINTE WOODS, MI 48236-1578
(240) 277-1483
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704323876
MI
Other
Enumeration date
06/15/2018
Last updated
07/28/2018
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