NPI | 1659336121 |
---|---|
Former Name | JAYNE L GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA VP006257G) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN519930L) |
Enumeration Date | 2006-04-19 |
Last Update Date | 2021-02-01 |