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NPI Code Detail

MEDICARE: JEFFREY E GRAND CRNA

MEDICARE: JEFFREY E GRAND CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistR129976MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1051037OTHERAANA #

General Provider Information

NPI Number : 1528046588
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY E GRAND CRNA
Provider Business Mailing Address
First Line : 8601 KIP DR
Second Line :
City : OWINGS
State : MD
Zip : 20736-9760
Country : US
Telephone Number : 410-535-8295
Fax Number : 410-414-4788
Provider Business Practice Location Address
First Line : 100 HOSPITAL RD
Second Line :
City : PRINCE FREDERICK
State : MD
Zip : 20678-4017
Country : US
Telephone Number : 410-535-8295
Fax Number : 410-414-4788
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 10/20/2011

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Directions to “ JEFFREY E GRAND CRNA” Practice Location

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