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 |