Provider Demographics
NPI:1003568551
Name:GRANTEED, ERICA (AG-ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:GRANTEED
Suffix:
Gender:F
Credentials:AG-ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15628 WHISPERING KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:VA
Mailing Address - Zip Code:20132-2569
Mailing Address - Country:US
Mailing Address - Phone:954-547-5150
Mailing Address - Fax:
Practice Address - Street 1:1855 WISCONSIN AVE NW STE A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2382
Practice Address - Country:US
Practice Address - Phone:202-992-8890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031040363L00000X
FLAPRN11018357363L00000X
TN33395363LA2100X
VA0024183550363LC0200X
MDAC004122363LC0200X
DC1030091363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine