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General NPI Number Information
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NPI Number | 1730477761
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Entity Type | Individual
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Provider Name | KARIN E GRANN N.P.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 112 MANSFIELD AVE
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City | WILLIMANTIC
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State | CT
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Zip | 06226-2045
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Country | US
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Telephone | 203-284-1340
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Fax | 203-265-4557
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Provider Business Mailing Address
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Address Line | PO BOX 4131
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City | YALESVILLE
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State | CT
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Zip | 06492-1481
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Country | US
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Telephone | 203-284-1340
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Fax | 203-265-4557
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4702
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License Number State | CT
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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 | 82608
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License Number State | CT
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