Healthcare Provider Details

I. General information

NPI: 1447784483
Provider Name (Legal Business Name): ARNITA GRANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6310 GREEN SPRING AVENUE SUITE 303
BALTIMORE MD
21209
US

IV. Provider business mailing address

6310 GREENSPRING AVE
BALTIMORE MD
21209-5500
US

V. Phone/Fax

Practice location:
  • Phone: 443-929-3228
  • Fax:
Mailing address:
  • Phone: 443-929-3228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number41878
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number41878
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: