Doctor Name: | MS. LISA GRANT |
NPI Number: | 1043348527 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | AP081515 |
Business Practice Address: | 34 Downeast Hwy Ellsworth, ME - 046051731 |
Business Phone Number: | 2076672288 |
Business Fax Number: | 2076676888 |
Mailing Address: | 1633 Bucksport Rd, ELLSWORTH |
State: | ME |
Postal Code: | 046052864 |
Phone Number: | 2076679558 |
Fax Number: | |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 06/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP081515 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |