Individual
JODI ELICIA GRANGER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
19611 SR 20 WEST, BLOUNTSTOWN, FL 32424
(850) 674-5645
(850) 674-5420
Mailing address
19611 SR 20 WEST, BLOUNTSTOWN, FL 32424
(850) 674-5645
(850) 674-5420
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9170397
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN
RN
FL
Enumeration date
06/12/2006
Last updated
07/08/2007
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