Blake Alan Grant, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Austin, TX. Individual provider (NPI-1).
NPI number1003522293
StatusActive
Last updated in NPPESAug 30, 2023
Details
- NPI
- 1003522293
- Entity type
- Individual (NPI-1)
- Name
- Mr. Blake Alan Grant
- Credential
- PMHNP-BC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2023
- Certification date
- Aug 30, 2023
- Last updated
- Aug 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 1109094 | TX | Yes |
Practice location
4005 Banister Ln Ste 200cAustin, TX 78704-8077
Phone 512-328-7222
Mailing address
4005 Banister Ln Ste 200cAustin, TX 78704-8077
Phone 806-893-1778
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