Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | RN152353 | GA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN152353 | GA |
NPI | 1306261441 |
---|---|
Provider Name | Mrs. April Reid Grant |
First Address | Augusta, GA 30912-0004 |
Second Address | Augusta, GA 30912-0004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2014 |
Last Update Date | 13/12/2016 |