Individual
JENNIFER MAHLBERG-GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
951 E PLAZA DR, STE 110, EAGLE, ID 83616-6567
(775) 738-5850
(775) 738-5856
Mailing address
3325 RESEARCH WAY, CARSON CITY, NV 89706-7913
(775) 888-6610
(775) 888-4904
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN002287
NV
363LW0102X
Women's Health Nurse Practitioner
Primary
53418
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN002287
APRN LICENSE
NV
Enumeration date
07/13/2017
Last updated
01/12/2021
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