Healthcare Provider Details

I. General information

NPI: 1164759742
Provider Name (Legal Business Name): JESSICA ERIN GRANATA DNP, FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3785 N FEDERAL HWY STE 300
BOCA RATON FL
33431-5900
US

IV. Provider business mailing address

19609 ESTUARY DR
BOCA RATON FL
33498-6202
US

V. Phone/Fax

Practice location:
  • Phone: 561-850-1185
  • Fax: 321-616-7676
Mailing address:
  • Phone: 617-285-6198
  • Fax: 321-616-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN263331
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number19041
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number40293
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9346569
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9346569
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19041
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number19041
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number40293
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: