| Elijah Walker Grant, | |
|
34 Lincoln St, Newton, MA 02461-1507 | |
| (508) 304-0843 | |
| Not Available |
| Full Name | Elijah Walker Grant |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 1 Years |
| Location | 34 Lincoln St, Newton, Massachusetts |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730073016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | RN2359945 (Massachusetts) | Secondary |
| 163W00000X | Registered Nurse | RN2359945 (Massachusetts) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Boston Medical Center Corporation- | Boston, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Devens Treatment And Recovery Center Llc | 8123319498 | 29 |
| Entity Name | Devens Treatment & Recovery Center LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811473267 PECOS PAC ID: 8123319498 Enrollment ID: O20181004001566 |
| Mailing Address | Practice Location Address |
|---|---|
| Elijah Walker Grant, 1309 Coffeen Ave Ste 1200, Sheridan, WY 82801-5777 Ph: (508) 304-0843 | Elijah Walker Grant, 34 Lincoln St, Newton, MA 02461-1507 Ph: (508) 304-0843 |
Yveline Charles, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 76 Webster Park, Newton, MA 02465 Phone: 617-279-1461 |
Ms. Sheila Frances Norton, CNM, ANP-BC Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2014 Washington St, Newton, MA 02462 Phone: 617-962-6096 |
Jessica J Tang, FNP-BC, IBCLC Registered Nurse Medicare: Medicare Enrolled Practice Location: 112 Warren St, Newton, MA 02459 Phone: 800-998-7042 Fax: 818-724-7704 |
Sarah Mcdonnell, DNP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 233 Needham St, Newton, MA 02464 Phone: 617-830-1644 |
Avery Mae Richard, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 233 Needham St Ste 430, Newton, MA 02464 Phone: 617-830-1644 |
Brandi Leigh Britnell, Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 233 Needham St Ste 300, Newton, MA 02464 Phone: 617-915-0117 |
Bryce Moore, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2014 Washington St, Newton, MA 02462 Phone: 617-243-6000 |