Grant, Kevin Lee

Grant, Kevin Lee is an individual health care provider with primary practice located at 1921 Stonecipher Dr , Ada OK 74820-3439. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Grant, Kevin Lee can be contacted via phone (580) 436-3980.

Contact Information

Primary practice address
1921 Stonecipher Dr Ada OK 74820-3439
Phone: (580) 436-3980
Fax: (580) 421-6283
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X R0049499 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R49499 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 643959 Texas

Profile Details

NPI number 1861438012
LBN Legal business name Grant, Kevin Lee
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jan 7th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861438012 NPPES
Oklahoma MEDICAID 100789110A

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