Abigail Renee Grant
Individual provider Active NPI Physician Assistant · Nitro, WV
NPI 1912539628 · NPPES record last updated Feb 11, 2020
Key facts
- NPI
- 1912539628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 123 Main Ave
Nitro, WV 25143-1270 - Phone
- (304) 550-7153
- NPI assigned
- Feb 11, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
123 Main Ave
Nitro, WV 25143-1270
Mailing address
123 Main Ave
Nitro, WV 25143-1270
Phone (304) 550-7153
Other providers in Nitro, WV
- Generations R.C. Inc.
- Franci B Geras
- Angela R Gibson
- Bethany Gibson
- Rebekah Leigh Giffin
- Olin David Green Jr.
- John H Hager
- Tracey Dawn Hager
- Charles Hall
- Tyler John Halstead
All providers in Nitro, WV · Physician Assistant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.