Provider Demographics
NPI:1780039651
Name:GRANT, RAHMAH (NP)
Entity Type:Individual
Prefix:
First Name:RAHMAH
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RAHMAH
Other - Middle Name:
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4735 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 2110
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2072
Mailing Address - Country:US
Mailing Address - Phone:302-623-0188
Mailing Address - Fax:302-623-0177
Practice Address - Street 1:4735 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 2110
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2072
Practice Address - Country:US
Practice Address - Phone:302-723-0188
Practice Address - Fax:302-623-0177
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162521163WC0200X, 363LC0200X
DELP0000163363LG0600X, 363LA2200X
DELP-0000163363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care