Provider Demographics
NPI:1013548650
Name:GRANT, VOLHA A (FNP)
Entity Type:Individual
Prefix:
First Name:VOLHA
Middle Name:A
Last Name:GRANT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 ROOSEVELT TRL
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-4904
Mailing Address - Country:US
Mailing Address - Phone:207-892-3233
Mailing Address - Fax:207-893-0752
Practice Address - Street 1:582 ROOSEVELT TRL
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4904
Practice Address - Country:US
Practice Address - Phone:207-892-3233
Practice Address - Fax:207-893-0752
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP191071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily