Individual
AMANDA GRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2600 S DECATUR BLVD, LAS VEGAS, NV 89102-8519
(702) 877-5199
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
851794
NV
363LF0000X
Family Nurse Practitioner
Primary
851794
NV
Other
Enumeration date
03/25/2022
Last updated
02/24/2025
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