Provider Demographics
NPI:1437706579
Name:GRANIERI, MARTIE B (BSN, RN-BC, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:MARTIE
Middle Name:B
Last Name:GRANIERI
Suffix:
Gender:F
Credentials:BSN, RN-BC, NBC-HWC
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:B
Other - Last Name:GRANIERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34106-0041
Mailing Address - Country:US
Mailing Address - Phone:609-318-3456
Mailing Address - Fax:
Practice Address - Street 1:6609 BISHOPGATE LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-8310
Practice Address - Country:US
Practice Address - Phone:609-318-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9389087163WC1500X
FL0271752163WP0808X
FL174152310174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health