Individual
MICHELLE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-4519
(207) 992-4132
Mailing address
141 N MAIN ST STE 205, BREWER, ME 04412-2055
(207) 973-4519
(207) 992-4132
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
043498
ME
Other
Enumeration date
09/21/2006
Last updated
03/27/2013
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