Individual
TYRONJALA SHONTEL GAINEY-GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
223 MEDICAL CENTER DR, RIVERDALE, GA 30274-2640
(770) 991-8500
Mailing address
223 MEDICAL CENTER DR, RIVERDALE, GA 30274-2640
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN175270
GA
Other
Enumeration date
11/19/2012
Last updated
09/19/2016
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