Individual
ANGELA MARIE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2321 E GALA ST STE 3, MERIDIAN, ID 83642-7692
(208) 888-5848
(208) 888-0884
Mailing address
5715 N DUXBURY PIER LN, GARDEN CITY, ID 83714-5021
(208) 921-1868
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53224
ID
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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