Individual
TANISHA NICOLE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8115 SIMSBURY DR, PORT RICHEY, FL 34668-5146
(813) 420-6873
Mailing address
8115 SIMSBURY DR, PORT RICHEY, FL 34668-5146
(813) 420-6873
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
FL
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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