Individual
MS. KIMBERLY GRANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
311 W LINCOLN ST STE 101, BELLEVILLE, IL 62220-1902
(618) 222-3200
(618) 222-3203
Mailing address
311 W LINCOLN ST, STE 201, BELLEVILLE, IL 62220-1902
(618) 222-3200
(618) 222-3203
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2015021523
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
209013529
IL
Other
Enumeration date
10/01/2015
Last updated
09/12/2018
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