Provider Demographics
NPI:1164665683
Name:GRANTSKI, SASHA (PA)
Entity Type:Individual
Prefix:MS
First Name:SASHA
Middle Name:
Last Name:GRANTSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4004 PIONEER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7548
Mailing Address - Country:US
Mailing Address - Phone:402-484-4900
Mailing Address - Fax:402-484-6456
Practice Address - Street 1:4004 PIONEER WOODS DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7548
Practice Address - Country:US
Practice Address - Phone:402-484-4900
Practice Address - Fax:402-484-6456
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE669363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical