Individual
RODNEY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2817 SAINT JOHNS BLVD, JOPLIN, MO 64804-1563
(417) 781-2727
(417) 625-2279
Mailing address
2817 SAINT JOHNS BLVD, JOPLIN, MO 64804-1563
(417) 781-2727
(417) 625-2279
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
106257
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100254770E
—
KS
05
—
100788080A
—
OK
05
—
918159534
—
MO
Enumeration date
03/02/2006
Last updated
02/10/2012
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