Individual
MR. KEITH GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN/FNP
Contact information
Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-5273
Mailing address
200 TRYON ST, MIDDLETOWN, CT 06457-4536
(860) 985-3725
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7972
CT
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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