Provider Demographics
NPI:1437238201
Name:GRANADOS, NANCY (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:GRANADOS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45239 NATS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-2875
Mailing Address - Country:US
Mailing Address - Phone:301-373-3511
Mailing Address - Fax:301-373-3511
Practice Address - Street 1:1731 BUNKER HILL RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3026
Practice Address - Country:US
Practice Address - Phone:202-832-4400
Practice Address - Fax:202-636-5389
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2008-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC7603065952363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics