Individual
MRS. PAULINE GRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-7453
Mailing address
2886 KINCAID ST, EUGENE, OR 97405-4156
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201393843LPN
OR
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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