Ladale L Grant FNP

NPI 1700219789 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1700219789
Gender Female
Enumeration Date 08/14/2013
Last Updated 08/14/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
3020 SAINT JOHNS BLVD
STE B
JOPLIN MO, 64804-1564, US
Phone (417) 206-4928
Fax (417) 627-8323
Business Location
3020 SAINT JOHNS BLVD
STE B
JOPLIN MO, 64804-1564, US
Phone (417) 206-4928
Fax (417) 627-8323
Toxanomy
Taxonomy Code 363LF0000X
License State Missouri
License Number 2013029344
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According to our database, Ladale L Grant FNP NPI is 1700219789, taxonomy code is 363LF0000X and license number is 2013029344, license state is located at Missouri. Ladale L Grant FNP physically located at 3020 Saint Johns Blvd, Joplin MO, 64804-1564. NPI Number Ladale L Grant FNP has the Individual type.

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1700219789 NPI number is provided on an as is basis without warranty of any kind. 1700219789 is maintained by the National Plan & Provider Enumeration System. The contents of Ladale L Grant FNP are for informational purposes only.