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General NPI Number Information
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NPI Number | 1427632108
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Entity Type | Individual
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Provider Name | KATHRYN WELLES GRANT CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 99 BARCLAY ST
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City | NEWTOWN
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State | PA
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Zip | 18940-1593
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Country | US
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Telephone | 215-860-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1929 N HOWARD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19122-2411
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP021304
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License Number State | PA
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