Individual
JESSICA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, AG-ACNP
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-1104
(434) 924-2101
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0024185256
VA
Other
Enumeration date
09/15/2022
Last updated
02/24/2025
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