Provider Demographics
NPI:1770783508
Name:GRANINGER, ELIZABETH MARIE (CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:GRANINGER
Suffix:
Gender:F
Credentials:CNM
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Other - Credentials:
Mailing Address - Street 1:2300 N FLORIDA MANGO RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6416
Mailing Address - Country:US
Mailing Address - Phone:561-296-4887
Mailing Address - Fax:561-472-9939
Practice Address - Street 1:7155 E 38TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-1630
Practice Address - Country:US
Practice Address - Phone:303-321-2458
Practice Address - Fax:303-321-0498
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2024-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0002067-CNM367A00000X
NVAPN000863367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000228376Medicaid