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1669611463
KIMBERLY LEACH GRANTHAM
SHREVEPORT, LA
NPI
1669611463
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA RN097823-AP05716)
Enumeration Date
2009-02-18
Last Update Date
2012-06-05
Business Address
-- KIMBERLY LEACH GRANTHAM CRNA
1171 PELICAN CREEK DR
SHREVEPORT, LA 71106-8539
Phone number: 318-780-0716
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Mailing Address
-- KIMBERLY LEACH GRANTHAM CRNA
1171 PELICAN CREEK DR
SHREVEPORT, LA 71106-8539
Phone number: 318-780-0716
Copy
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