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General NPI Number Information
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NPI Number | 1518124445
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Entity Type | Individual
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Provider Name | MEGGAN JUSTINE GRANT-NIERMAN DO
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 110 OLD STAGE RD UNIT A
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City | SALIDA
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State | CO
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Zip | 81201-8942
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Country | US
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Telephone | 719-867-6330
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Fax | 719-785-0530
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Provider Business Mailing Address
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Address Line | 110 OLD STAGE RD UNIT A
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City | SALIDA
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State | CO
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Zip | 81201-8942
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Country | US
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Telephone | 719-867-6330
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Fax | 719-785-0530
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6951
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 51137
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License Number State | CO
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