Neltie Curtis Grandstaff IV, RN

Individual provider Active NPI Registered Nurse · Cedar, MI

NPI 1841709045 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1841709045
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
4704241635 (MI)
Practice address
7135 E Hoxie Rd
Cedar, MI 49621
Phone
(231) 645-0712
NPI assigned
Sep 20, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704241635MIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704241635 MI Yes

Addresses

Primary practice location

7135 E Hoxie Rd
Cedar, MI 49621

Mailing address

7135 E Hoxie Rd
Cedar, MI 49621-9414
Phone (231) 645-0712

Other providers in Cedar, MI

All providers in Cedar, MI · Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.