Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mr. Derek Shaune Grantham

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1487485546

Mr. Derek Shaune Grantham is a Student in an Organized Health Care Education/Training Program in Pocatello, Idaho. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Pocatello, ID

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Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1487485546
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 12, 2024
Last updated in NPPESSeptember 16, 2026
Certification dateSeptember 16, 2026

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