Individual
ALISA GRANGER MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3603 6TH AVE S, ST PETERSBURG, FL 33711-1715
(727) 454-9443
Mailing address
3603 6TH AVE S, ST PETERSBURG, FL 33711-1715
(727) 454-9443
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN2968372
FL
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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