Provider Demographics
NPI:1881443463
Name:GRAGNANO, LINDSAY ERIN (FNP)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:ERIN
Last Name:GRAGNANO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 N DYSART RD STE G127
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-1011
Mailing Address - Country:US
Mailing Address - Phone:623-322-0323
Mailing Address - Fax:623-322-0757
Practice Address - Street 1:3400 N DYSART RD STE G127
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1011
Practice Address - Country:US
Practice Address - Phone:623-322-0323
Practice Address - Fax:623-322-0757
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ307340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily