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General NPI Number Information
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NPI Number | 1356076228
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Entity Type | Individual
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Provider Name | SHAYLAH GRANT NP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2022
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 121 LINCOLN ST STE 2R
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City | WORCESTER
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State | MA
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Zip | 01605-2429
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Country | US
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Telephone | 508-388-1325
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Fax |
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Provider Business Mailing Address
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Address Line | 121 LINCOLN ST STE 2R
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City | WORCESTER
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State | MA
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Zip | 01605-2429
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Country | US
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Telephone | 508-388-1325
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN2324295
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2324295
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License Number State | MA
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