Provider Demographics
NPI:1710100946
Name:GRANT, GLENDA ROBINETTE (RN)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:ROBINETTE
Last Name:GRANT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1330 5TH ST NE APT 81
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2085
Mailing Address - Country:US
Mailing Address - Phone:828-322-2050
Mailing Address - Fax:828-324-4271
Practice Address - Street 1:3521 GRAYSTONE PL
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8201
Practice Address - Country:US
Practice Address - Phone:828-322-2050
Practice Address - Fax:828-324-4271
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC047685163W00000X, 163WX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WX1100XNursing Service ProvidersRegistered NurseOphthalmic