Individual
ALLYSON M GRANDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
12266 DEPAUL DRIVE, SUITE 205, SAINT LOUIS, MO 63044-2727
(314) 218-2300
(314) 646-1700
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2018038914
MO
Other
Enumeration date
02/08/2019
Last updated
10/22/2020
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