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Individual

TACY GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
3600 BLUECUTT RD STE 301, COLUMBUS, MS 39705-1397
(662) 329-2215
Mailing address
3600 BLUECUTT RD, COLUMBUS, MS 39705-1303
(662) 329-2215

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903441
MS

Other

Enumeration date
06/25/2019
Last updated
12/03/2025
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