Individual
CAROLYN M GRANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 615-5858
Mailing address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 615-5858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
UP005430X
PA
Other
Enumeration date
12/18/2006
Last updated
03/01/2013
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