Healthcare Provider Details

I. General information

NPI: 1710881024
Provider Name (Legal Business Name): KAREN SANDWICK GRANGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 IRVING PKWY STE 230
HOLLY SPRINGS NC
27540-5301
US

IV. Provider business mailing address

401 IRVING PKWY STE 230
HOLLY SPRINGS NC
27540-5301
US

V. Phone/Fax

Practice location:
  • Phone: 919-385-8850
  • Fax: 919-385-8874
Mailing address:
  • Phone: 919-385-8850
  • Fax: 919-385-8874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number270310
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: