Healthcare Provider Details

I. General information

NPI: 1497718621
Provider Name (Legal Business Name): KATHY ANN GRANGER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 N ELM ST
HIGH POINT NC
27262-3918
US

IV. Provider business mailing address

1939 JERICO RD
ASHEBORO NC
27205-2674
US

V. Phone/Fax

Practice location:
  • Phone: 336-889-3646
  • Fax: 336-889-9993
Mailing address:
  • Phone: 336-625-6836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number1947442
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number233
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: