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General NPI Number Information
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NPI Number | 1447814132
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Entity Type | Individual
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Provider Name | ELIZABETH WHITE GRANT MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/28/2019
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 2450 RIVERSIDE AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-1400
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Country | US
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Telephone | 612-672-7700
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Fax | 952-848-8892
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Provider Business Mailing Address
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Address Line | 2105 EMERSON AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55405-2627
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Country | US
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Telephone | 415-516-2426
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11664
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95010377
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License Number State | CA
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