Guillermo Grant, CRNP
Nurse Practitioner, Primary Care in Washington, DC. Individual provider (NPI-1).
NPI number1669995437
StatusActive
Last updated in NPPESMay 18, 2021
Details
- NPI
- 1669995437
- Entity type
- Individual (NPI-1)
- Name
- Guillermo Grant
- Credential
- CRNP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 24, 2017
- Certification date
- May 18, 2021
- Last updated
- May 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | RN1011343 | DC | Yes |
| 363LF0000X | Nurse Practitioner, Family | RN101143 | DC |
Practice location
1220 12th St SeWashington, DC 20003-3722
Phone 202-279-1819 · Fax 202-617-2985
Mailing address
5941 Addison RdCapitol Heights, MD 20743-2166
Phone 301-343-6298
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