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General NPI Number Information
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NPI Number | 1699584060
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Entity Type | Individual
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Provider Name | ANDREA LEANORIA GRANT FNP
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Gender | Female
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 100 S CENTER ST
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City | THURMONT
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State | MD
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Zip | 21788-1945
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Country | US
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Telephone | 301-696-8801
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Fax | 301-696-0186
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Provider Business Mailing Address
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Address Line | 9369 HIGHLANDER BLVD
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City | WALKERSVILLE
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State | MD
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Zip | 21793-9114
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Country | US
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Telephone | 301-730-1442
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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 | 2024097620
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License Number State | MD
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