Grant, Laurel Ruth
Grant, Laurel Ruth is an individual health care provider with primary practice located at 1027 Memorial Dr , Oakland MD 21550-4343. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Grant, Laurel Ruth can be contacted via phone (301) 533-3300.Contact Information
Primary practice address
1027 Memorial Dr
Oakland MD 21550-4343
Phone: (301) 533-3300
Fax: (301) 533-3299
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RO65152 | Maryland |
Profile Details
| NPI number | 1487750170 |
|---|---|
| LBN Legal business name | Grant, Laurel Ruth |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Jul 14th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487750170 | NPPES |
| Maryland | MEDICAID | 062402100 | |
| Maryland | MEDICAID | 7102051000 |
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