Healthcare Provider Details

I. General information

NPI: 1770783508
Provider Name (Legal Business Name): ELIZABETH MARIE GRANINGER C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7155 E 38TH AVE
DENVER CO
80207-1630
US

IV. Provider business mailing address

2300 N FLORIDA MANGO RD
WEST PALM BEACH FL
33409-6416
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-2458
  • Fax: 303-321-0498
Mailing address:
  • Phone: 561-296-4887
  • Fax: 561-472-9939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN.0002067-CNM
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN000863
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: