Individual
SARA LAURENE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8001 T W ALEXANDER DR, RALEIGH, NC 27617-4883
(919) 350-0953
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-14183
NC
363A00000X
Physician Assistant
PA9113596
FL
363AM0700X
Medical Physician Assistant
Primary
0010-14183
NC
363AM0700X
Medical Physician Assistant
PA9113596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710591516
—
NC
Enumeration date
08/31/2020
Last updated
10/03/2024
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