Provider Demographics
NPI:1184070856
Name:GRANTIER, CARA J (CNP)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:J
Last Name:GRANTIER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:CHAMPION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-3196
Mailing Address - Fax:
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-5066
Practice Address - Fax:614-293-4812
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.410582163W00000X
OHCOA.19212-NP363LF0000X
OHAPRNCNP19212363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily