Grayson Brian Grant
Nurse Practitioner, Family in Jonesboro, AR. Individual provider (NPI-1).
NPI number1164098216
StatusActive
Last updated in NPPESMar 23, 2022
Details
- NPI
- 1164098216
- Entity type
- Individual (NPI-1)
- Name
- Grayson Brian Grant
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 30, 2021
- Certification date
- Mar 10, 2022
- Last updated
- Mar 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 215174 | AR | Yes |
Practice location
1007 E Matthews AveJonesboro, AR 72401-4308
Phone 870-336-0472
Mailing address
1007 E Matthews AveJonesboro, AR 72401-4308
Phone 870-336-0472
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