Provider Demographics
NPI:1942512736
Name:GRANT, NATSHA MONIQUE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:NATSHA
Middle Name:MONIQUE
Last Name:GRANT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FORCE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-5810
Mailing Address - Country:US
Mailing Address - Phone:216-240-5535
Mailing Address - Fax:
Practice Address - Street 1:7900 FORCE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-5810
Practice Address - Country:US
Practice Address - Phone:216-240-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH138903164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse