Individual
TRICIA KAYE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
20370 POE SHOLES DR, BEND, OR 97701-7938
(541) 318-1377
Mailing address
20370 POE SHOLES DR, BEND, OR 97701-7938
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
099007622RN
OR
Other
Enumeration date
02/19/2012
Last updated
02/19/2012
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