Individual
HEIDI GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2415 NW 36TH TER, GAINESVILLE, FL 32605-2633
(352) 380-0786
Mailing address
2415 NW 36TH TER, GAINESVILLE, FL 32605-2633
(352) 380-0786
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 541261
FL
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
PN 5411261
FL
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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