Healthcare Provider Details

I. General information

NPI: 1639199235
Provider Name (Legal Business Name): DAYNA GRANSTON RN, RXN, CNS, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1634 WALNUT ST STE 201
BOULDER CO
80302-5400
US

IV. Provider business mailing address

910 HAWTHORN AVE
BOULDER CO
80304-2144
US

V. Phone/Fax

Practice location:
  • Phone: 303-818-8263
  • Fax: 844-272-1680
Mailing address:
  • Phone: 303-443-9634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number91024
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRXN-0001430-CNS
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: