Individual
TIANA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 FRANCIS ST, CWN L-1, BOSTON, MA 02115
(617) 525-9542
(617) 277-2192
Mailing address
75 FRANCIS ST, CWN L-1, BOSTON, MA 02115
(617) 525-9542
(617) 277-2192
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
738529
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN10020133
MA
367500000X
Certified Registered Nurse Anesthetist
RN738529
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
738529
738529
PA
Enumeration date
07/01/2021
Last updated
03/11/2025
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