Individual
MR. JOHN J GRANDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2101 E JEFFERSON ST, ROCKVILLE, MD 20852-4908
(202) 898-5104
(202) 898-5474
Mailing address
2101 EAST JEFFERSON STREET, PPQA MEDICARE COMPLIANCE UNIT 6 WEST, ROCKVILLE, MD 20852-4908
(301) 816-2414
(301) 388-1740
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN47957
DC
Other
Enumeration date
12/01/2006
Last updated
01/05/2012
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