Individual
LASHONDA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.N.A
Contact information
Practice address
2134 BO PEEP DR W, JACKSONVILLE, FL 32210-2918
(904) 476-9743
(904) 786-9759
Mailing address
2134 BO PEEP DR W, JACKSONVILLE, FL 32210-2918
(904) 476-9743
(904) 786-9759
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
123348
FL
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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