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General NPI Number Information
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NPI Number | 1134527245
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Entity Type | Individual
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Provider Name | MARQUITA GRANDA MSN, FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 5972 HEAMOI PL
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City | KAPAA
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State | HI
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Zip | 96746-9704
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Country | US
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Telephone | 808-722-7710
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Fax |
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Provider Business Mailing Address
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Address Line | 5972 HEAMOI PL
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City | KAPAA
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State | HI
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Zip | 96746-9704
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Country | US
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Telephone | 808-722-7710
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60733123
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN1837
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201603089NP-PP
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202009723NP-PP
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN1837
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License Number State | HI
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