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SHIRLEY R GRANT
Psychiatric/Mental Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1699437970
Individual Registrant: SHIRLEY R GRANT
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
2927 DEMERE RD ST SIMONS ISLAND, GA 31522-1620 US
Tel: 912-638-1999 Fax: --
Tel: 912-638-1999 Fax: --
Contact information for business:
529 DERRICK INN RD SAVANNAH, GA 31405-9423 US
Tel: 912-660-5974 Fax: --
Tel: 912-660-5974 Fax: --
Registration Information:
NPI: 1699437970
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Psychiatric/Mental Health | GA | RN130320 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
