| Doctor Name: | MRS. LISA JANELLE GRANT |
| NPI Number: | 1285717736 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 2234 |
| Business Practice Address: | 55 Fogg Rd South Shore Hospital Emergency Department South Weymouth, MA - 021902432 |
| Business Phone Number: | 7813403627 |
| Business Fax Number: | |
| Mailing Address: | 43 Heritage Hl, DEDHAM |
| State: | MA |
| Postal Code: | 020266206 |
| Phone Number: | 6179997093 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 06/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 2234 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |