Individual
ELIJAH WALKER GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34 LINCOLN ST, NEWTON, MA 02461-1507
(508) 304-0843
Mailing address
1309 COFFEEN AVE STE 1200, SHERIDAN, WY 82801-5777
(508) 304-0843
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2359945
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN2359945
MA
Other
Enumeration date
06/03/2025
Last updated
09/19/2025
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