Individual
MARIAN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6701 N CHARLES ST STE 4105, BALTIMORE, MD 21204-6808
(443) 849-3184
Mailing address
PO BOX 631568, BALTIMORE, MD 21263-1568
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R149194
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408022000
—
MD
Enumeration date
04/17/2006
Last updated
07/24/2009
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