Individual
TERRI-ANN K GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
211 SUDDERTH DR, RUIDOSO, NM 88345-6002
(575) 257-8200
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2021207711
NJ
363LF0000X
Family Nurse Practitioner
Primary
78333
NM
Other
Enumeration date
08/29/2022
Last updated
06/07/2024
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