Provider Demographics
NPI:1982471306
Name:GRAINGER, COLLEEN (CNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:GRAINGER
Suffix:
Gender:F
Credentials:CNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3958 LEAP RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-3107
Mailing Address - Country:US
Mailing Address - Phone:614-571-0152
Mailing Address - Fax:
Practice Address - Street 1:3958 LEAP RD STE 101
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-3107
Practice Address - Country:US
Practice Address - Phone:614-876-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily