Healthcare Provider Details

I. General information

NPI: 1972449114
Provider Name (Legal Business Name): HALEY GRANGER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 TOWNSHIP LINE RD FL 2
YARDLEY PA
19067-5552
US

IV. Provider business mailing address

223 COLLINGSWOOD RD
FAIRLESS HILLS PA
19030-1303
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-0775
  • Fax:
Mailing address:
  • Phone: 336-552-8414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP034521
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: