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Individual

SUSAN HUGGINS GRAINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
240 BROAD ST, DBA FORSYTH PEDIATRIC ASSOC. - K'VILLE, KERNERSVILLE, NC 27284-2930
(336) 993-8333
(336) 993-5144
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
086287
NC
363L00000X
Nurse Practitioner
Primary
300252
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7005439
NC
Enumeration date
01/27/2006
Last updated
12/23/2021
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