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General NPI Number Information
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NPI Number | 1982276150
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Entity Type | Individual
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Provider Name | KYLA KRISTINE GRANT DNP
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Gender | Female
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 7301 ROGERS AVE FL 4
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City | FORT SMITH
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State | AR
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Zip | 72903-4100
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Country | US
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Telephone | 479-314-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 5224 75TH ST STE D
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City | LUBBOCK
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State | TX
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Zip | 79424-2525
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Country | US
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Telephone | 806-712-1096
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Fax | 806-771-2093
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 216132
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 216132
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 216132
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License Number State | AR
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