Marilou Grant, CRNP
Individual provider Active NPI Family Nurse Practitioner · Old Forge, PA
NPI 1962629428 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962629428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- UP004462B (PA)
- Practice address
- 314 Oak St
Old Forge, PA 18518-1619 - Phone
- (570) 457-7150
- Fax
- (570) 457-8611
- NPI assigned
- Apr 19, 2007
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UP004462B | PA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | UP004462B | PA | Yes |
Addresses
Primary practice location
314 Oak St
Old Forge, PA 18518-1619
Mailing address
518 Hill St
Duryea, PA 18642-1619
Phone (570) 457-0218
Other providers in Old Forge, PA
- Krista Lynn Galella
- Robin Gallagher
- Gina Gatto-Harris
- Michelle L Gauntlett
- Kristina Grande
- Anthony J Grasso Jr.
- Graziano Chiropractic
- Lana Grzybicki
- Anthony Guillorn
- H & H Counseling
All providers in Old Forge, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.