Individual ProviderDavina GrantNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3115 E Verbena Dr, Phoenix, AZ 85048-8758(336) 287-3519PECOS EnrollmentBased on the most recent information from CMS, provider Davina Grant is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1871146100Provider TypeIndividualFull NameGrant, DavinaCredentialNP-CGenderFemaleSole ProprietorNoEnumeration Date7/16/2019Last Updated7/16/2019Contact InformationPractice LocationPractice Address3115 E Verbena Dr, Phoenix, AZ 85048-8758Phone(336) 287-3519FaxUnlisted FaxMailing LocationMailing Address3115 E Verbena Dr, Phoenix, AZ 85048-8758Phone(336) 287-3519FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense229406Arizona