Individual provider · Type 1 NPI

Nicholas J. Grande Jr., PAC

Medical Physician Assistant · Davenport, IA

NPI number 1316085756 Active

Practice location

1227 E Rusholme St
Davenport, IA 52803-2459

Mailing address

650 Huebner Rd
Fort Riley, KS 66442-4030

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1316085756

Nicholas J. Grande Jr., PAC's National Provider Identifier is 1316085756, issued on Feb 1, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Davenport, IA. The record was last updated on Feb 16, 2023.