Individual
CHARLEE JENNA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
504 REDMOND RD NW, ROME, GA 30165-1416
(762) 235-2200
(706) 236-6434
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN305600
GA
Other
Enumeration date
08/13/2021
Last updated
10/13/2021
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