Grantham, Myra Jo

Grantham, Myra Jo is an sole proprietor health care provider with primary practice located at 2302 College Ave , Conway AR 72034-6297. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Student Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Grantham, Myra Jo can be contacted via phone (501) 329-3831.

Contact Information

Primary practice address
2302 College Ave Conway AR 72034-6297
Phone: (501) 329-3831
Fax: (501) 450-2283
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Student Health 261QS1000X A004270 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X A004270 Arkansas

Profile Details

NPI number 1528459799
LBN Legal business name Grantham, Myra Jo
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 10th, 2015
Last updated Jun 10th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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