MACKENZIE GRANT

PORTLAND, ME
NPI1558992552
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: ME  CNP221665)
Additional Taxonomies363LP0200X Nurse Practitioner, Pediatrics
(Licence: MA  2300770)
Enumeration Date2020-01-28
Last Update Date2025-01-08
Business Address
MACKENZIE GRANT ACPNP
22 BRAMHALL ST
PORTLAND, ME 04102-3134
Phone number: 207-772-8850
Mailing Address
MACKENZIE GRANT ACPNP
22 BRAMHALL ST
PORTLAND, ME 04102-3134
Phone number: 207-662-2414
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