Individual
KELLY KIRKMAN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
510 N ELAM AVE STE 202, GREENSBORO, NC 27403-1177
(336) 299-3183
(336) 299-1762
Mailing address
510 N ELAM AVE STE 202, GREENSBORO, NC 27403-1177
(336) 299-3183
(336) 299-1762
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
200614
NC
363LF0000X
Family Nurse Practitioner
Primary
200614
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200614
PE#
NC
Enumeration date
06/13/2005
Last updated
04/24/2018
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