Provider Demographics
NPI:1881487569
Name:GRANT, BRIAN D
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:GRANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13254 S 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-2252
Mailing Address - Country:US
Mailing Address - Phone:402-709-3591
Mailing Address - Fax:
Practice Address - Street 1:13254 S 38TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-2252
Practice Address - Country:US
Practice Address - Phone:402-709-3591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion