Individual
PAMELA K. GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, CPNP
Contact information
Practice address
15420 N. 32ND DRIVE, PHOENIX, AZ 85053-3998
(602) 866-1974
(602) 375-3949
Mailing address
15420 N. 32ND DRIVE, PHOENIX, AZ 85053-3998
(602) 866-1974
(602) 375-3949
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP1990
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
963670
—
AZ
Enumeration date
09/17/2006
Last updated
07/19/2019
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