Provider Demographics
NPI:1417057969
Name:GRAINGER, R. DAILEY (PHD, ARNP, BC)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:DAILEY
Last Name:GRAINGER
Suffix:
Gender:F
Credentials:PHD, ARNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-4125
Mailing Address - Country:US
Mailing Address - Phone:305-393-3600
Mailing Address - Fax:305-664-5350
Practice Address - Street 1:83266 OVERSEAS HWY
Practice Address - Street 2:SUITE 500
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3520
Practice Address - Country:US
Practice Address - Phone:305-393-3600
Practice Address - Fax:305-664-5350
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL187132363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FM187132OtherARNP LICENSE NUMBER
FLY2278AOtherMEDICARE/BCBS #
FLY2278AOtherMEDICARE/BCBS #