Individual
GRETA EVE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9101 PINEVILLE MATTHEWS RD STE D, PINEVILLE, NC 28134-8826
(704) 323-3300
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07289
NC
363A00000X
Physician Assistant
2834
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730027
NSC #
NC
Enumeration date
06/17/2014
Last updated
06/02/2022
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