Individual
NICOLE GRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
581 W 1600 N, OREM, UT 84057-2571
(180) 147-3396
(801) 797-1220
Mailing address
2414 ACADIANA LN, SEABROOK, TX 77586-8309
(180) 147-3396
(801) 797-1220
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/25/2020
Last updated
09/10/2020
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