Individual
MRS. CYNTHIA A GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-4123
(864) 560-4023
Mailing address
PO BOX 277723, ATLANTA, GA 30384-7723
(864) 560-4123
(864) 560-4023
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4204
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2087
—
SC
01
—
P00905777
RAILROAD MEDICARE
SC
Enumeration date
03/04/2010
Last updated
05/06/2011
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