GRANT PENN CHANIN

ALBUQUERQUE, NM
NPI1225488018
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: NM  CNP-02952)
Enumeration Date2016-06-13
Last Update Date2024-01-31
Business Address
Mr. GRANT PENN CHANIN CNP
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106-4930
Phone number: 505-841-1125
Mailing Address
Mr. GRANT PENN CHANIN CNP
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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