Healthcare Provider Details

I. General information

NPI: 1285368571
Provider Name (Legal Business Name): BRITTNEY TAYLOR GRANT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 E BELTLINE AVE NE FL 1
GRAND RAPIDS MI
49525-8614
US

IV. Provider business mailing address

100 MICHIGAN ST NE MC 845
GRAND RAPIDS MI
49503
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-6271
  • Fax:
Mailing address:
  • Phone: 616-486-6790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704334889
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: