Healthcare Provider Details
I. General information
NPI: 1003568551
Provider Name (Legal Business Name): ERICA GRANTEED AG-ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/25/2022
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1341 CONNECTICUT AVE NW STE 4.2
WASHINGTON DC
20036-1890
US
IV. Provider business mailing address
15628 WHISPERING KNOLL CT
HILLSBORO VA
20132-2569
US
V. Phone/Fax
- Phone: 202-800-0612
- Fax:
- Phone: 954-547-5150
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | C-RXN.0102427-C-NP |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 13233 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | LP-0010830 |
| License Number State | DE |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 277.004278 |
| License Number State | IL |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LC0200X |
| Taxonomy | Critical Care Medicine Nurse Practitioner |
| License Number | 0024183550 |
| License Number State | VA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | GAA-NP001289 |
| License Number State | GA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 78515 |
| License Number State | ID |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LC0200X |
| Taxonomy | Critical Care Medicine Nurse Practitioner |
| License Number | AC004122 |
| License Number State | MD |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 1030091 |
| License Number State | DC |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN.CNP.0031040 |
| License Number State | OH |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN11018357 |
| License Number State | FL |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 33395 |
| License Number State | TN |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 3-001856 |
| License Number State | AL |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 316652 |
| License Number State | AZ |
| # 15 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 230753 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
