Individual
MICHELLE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
130 MARK CIR, MONTICELLO, AR 71655-5617
(870) 723-5376
Mailing address
130 MARK CIR, MONTICELLO, AR 71655-5617
(870) 723-5376
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
122325
AR
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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