Individual provider · Type 1 NPI

Jacquelyn Alberta Granquist, PA-C

Surgical Physician Assistant · Iron Mountain, MI

NPI number 1780760744 Active

Practice location

325 E H St
Iron Mountain, MI 49801-4760

Call (906) 774-3300 Map

Mailing address

904 Bluff Ave
Kingsford, MI 49802-1221

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X5601004834 (MI)

Surgical Physician Assistant: Definition to come...

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About NPI 1780760744

Jacquelyn Alberta Granquist, PA-C's National Provider Identifier is 1780760744, issued on Oct 31, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Iron Mountain, MI. The record was last updated on Apr 18, 2019.