Healthcare Provider Details

I. General information

NPI: 1174325104
Provider Name (Legal Business Name): DANIELLE GRANT CRNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 HOSPITAL DR
GLEN BURNIE MD
21061-5803
US

IV. Provider business mailing address

7521 BALEEN CT
GLEN BURNIE MD
21061-9503
US

V. Phone/Fax

Practice location:
  • Phone: 410-787-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR246461
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberR246461
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License NumberR246461
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: