Mary Grant, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R538515 Issued in MS

Practice address

9140 Highway 51 N
Southaven, MS 38671-1233

Phone

(662) 280-8222

Fax

(662) 280-5541

NPI assigned

Jul 22, 2008

Last updated

Jul 22, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delta Medical Weight Management Inc

  • Health Service Clinic/Center
  • Southaven, MS
  • NPI 1871731182
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1093970733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 HIGHWAY 51 N",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711233",
            "telephone_number": "662-280-8222",
            "fax_number": "662-280-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9140 HIGHWAY 51 N",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711233",
            "telephone_number": "662-280-8222",
            "fax_number": "662-280-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R538515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie Bea Govan, OD, MS
• Gracefull Solutions LLC
• Madison Nicole Grafe
• Amy Renae Graham, DPT
• Javel Granados, MD
• Katherine Rivers Graves, AU.D.
• Madeleine Kayne Graves, P-LPC
• Keshell Antron Gray, M.S., CCC-SLP
• Madeline Marie Gray, LMSW
• Wesley Allen Gray, NP

• Family Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.