Individual
MS. DIANNE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(817) 250-2551
Mailing address
920 CHANCELLORSVILLE PKWY, GRAND PRAIRIE, TX 75052-1638
(817) 675-7563
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1018083
TX
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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