Individual
MARKESHA NICOLE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
225 CHAMPAGNE ST, GREENWOOD, MS 38930-7506
(901) 870-4881
Mailing address
225 CHAMPAGNE ST, GREENWOOD, MS 38930-7506
(901) 870-4881
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
251364
TN
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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