Brenda L Grant, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2002028541 Issued in MO

Practice address

4585 Washington St
Suite a-4
Florissant, MO 63033-5858

Phone

(314) 402-4693

NPI assigned

Apr 22, 2009

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1164666178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 CROSS KEYS PLACE DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630333129",
            "telephone_number": "314-402-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 WASHINGTON ST",
            "address_2": "SUITE A-4",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630335858",
            "telephone_number": "314-402-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "BRENDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2002028541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lavette Marachelle Graham-Pennington
• Jordyn Leigh Graham
• Joyce Graham, LPC
• Laura M Gramolino, FNP-C
• Cherise Grandison
• Courtney M Graves, LPC
• Meghan Anne Gravlin, DPT
• Tracie Gray
• Cindy Graydon
• Betty Ann Green, LPC

• Licensed Practical Nurse in Florissant, MO
• Providers in Florissant, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.