Provider Demographics
NPI:1124825419
Name:GRANI, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:GRANI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25555 15TH AVE N
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56549-9214
Mailing Address - Country:US
Mailing Address - Phone:701-371-9345
Mailing Address - Fax:
Practice Address - Street 1:25555 15TH AVE N
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:MN
Practice Address - Zip Code:56549-9214
Practice Address - Country:US
Practice Address - Phone:701-371-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program