Provider Demographics
NPI:1528854791
Name:GRAND, ANTOINETTE MORRIS (CGFM, PMP)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:MORRIS
Last Name:GRAND
Suffix:
Gender:F
Credentials:CGFM, PMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 KITTERY DR # 31301
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-3529
Mailing Address - Country:US
Mailing Address - Phone:719-679-6006
Mailing Address - Fax:
Practice Address - Street 1:6958 KETCHUM DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-9406
Practice Address - Country:US
Practice Address - Phone:317-801-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care