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NPI Code Detail

MEDICARE: MR. ALFRED JAMES GRANT IV RN, BSN

MEDICARE: MR. ALFRED JAMES GRANT IV RN, BSN
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
1163WG0000XGeneral Practice Registered NurseL1-0041760DE

General Provider Information

NPI Number : 1952025371
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALFRED JAMES GRANT IV RN, BSN
Provider Business Mailing Address
First Line : 1402 VEALE RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19810-4332
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2220 SHIPLEY RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-2306
Country : US
Telephone Number : 302-479-1623
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2022
Last Update Date : 09/29/2022

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