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Individual

TAVANNA GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
2934 KEMP BLVD, WICHITA FALLS, TX 76308-1017
(940) 691-1899
Mailing address
PO BOX 924, VERNON, TX 76385-0924

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1074646
TX

Other

Enumeration date
06/27/2022
Last updated
12/13/2024
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