STACIE K GRANTHAM

JACKSON, TN
NPI1215175278
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TN  APN13513)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: TN  13513)
363LF0000X Nurse Practitioner, Family
(Licence: TN  APN13513)
Enumeration Date2009-01-29
Last Update Date2021-09-07
Business Address
Mrs. STACIE K GRANTHAM CFNP
587 SKYLINE DR
JACKSON, TN 38301-3938
Phone number: 731-424-8922
Mailing Address
Mrs. STACIE K GRANTHAM CFNP
587 SKYLINE DR
JACKSON, TN 38301-3938
Phone number: 731-424-8922