| NPI | 1013311380 |
|---|---|
| Former Name | SHANNA LYNN GRANBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV APRN001861) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV APRN001861) |
| 163W00000X Registered Nurse (Licence: NV RN65758) | |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2023-03-03 |