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Individual

MRS. GIANNA M GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
104 E GROVE ST, EL DORADO, AR 71730-4607
(870) 862-2285
(870) 862-2289
Mailing address
104 E GROVE ST, EL DORADO, AR 71730-4607
(870) 862-2285
(870) 862-2289

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R56286
AR
363LF0000X
Family Nurse Practitioner
Primary
A01853
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158023758
AR
Enumeration date
03/09/2006
Last updated
06/10/2019
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