Provider Demographics
NPI:1679310429
Name:GRANT, VERONICA J
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:J
Last Name:GRANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 SILVER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-1577
Mailing Address - Country:US
Mailing Address - Phone:443-603-2055
Mailing Address - Fax:
Practice Address - Street 1:534 SILVER LAKE DR
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-1577
Practice Address - Country:US
Practice Address - Phone:443-603-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion