| NPI | 1922438357 |
|---|---|
| Former Name | MARYBETH GRANNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R175707) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MD R175707) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: DC RN1007233) | |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2024-09-17 |