Marvel Lucretia Grant

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

11008524 Issued in FL

Practice address

6600 NW 34TH Ave
Fort Lauderdale, FL 33309-1225

Phone

(954) 494-7564

NPI assigned

Jul 23, 2020

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596844800000",
    "number": "1831708015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 NW 34TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091225",
            "telephone_number": "954-494-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 NW 34TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091225",
            "telephone_number": "954-494-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MARVEL",
        "middle_name": "LUCRETIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-08-08",
        "certification_date": "2020-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11008524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Anthony Granger III, MPH, CHES
• Andrea Marie Granston-Leslie, LMHC
• Jamilah Grant-Guimaraes, MD
• Arlene Grant
• Denise Rosita Grant, LCSW
• Nancy Elena Grant, LMHC
• Grateful Guidance LLC
• Marie J Gravel Solano, PA-C
• Gravity X LLC
• Angelis Gray

• Acute Care Nurse Practitioner in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2020; 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.