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Individual

GRANT WYSONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7250 CLEARVISTA DR STE 355, INDIANAPOLIS, IN 46256-5609
(317) 621-6262
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-1699

Taxonomy

Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
28222590A
IN
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
71016996A
IN

Other

Enumeration date
08/20/2025
Last updated
09/02/2025
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