Individual provider · Type 1 NPI

Myra Jo Grantham, NP

Family Nurse Practitioner · Conway, AR

NPI number 1528459799 Active

Practice location

2302 College Ave
Conway, AR 72034-6297

Call (501) 329-3831 Map

Fax (501) 450-2283

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870

Specialties and licenses

TaxonomyCodeLicense
Student Health Clinic/Center 261QS1000XA004270 (AR)
Family Nurse Practitioner Primary 363LF0000XA004270 (AR)

Family Nurse Practitioner: Definition to come...

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About NPI 1528459799

Myra Jo Grantham, NP's National Provider Identifier is 1528459799, issued on Feb 10, 2015. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Conway, AR. The record was last updated on Jun 10, 2019.