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General NPI Number Information
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NPI Number | 1225688427
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Entity Type | Individual
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Provider Name | SUSAN M. GRANATO CNP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 6410 ROCKLEDGE DR STE 660
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City | BETHESDA
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State | MD
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Zip | 20817-1915
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Country | US
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Telephone | 301-571-0019
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Fax | 240-482-0555
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Provider Business Mailing Address
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Address Line | PO BOX 749495
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City | ATLANTA
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State | GA
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Zip | 30374-9495
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Country | US
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Telephone | 855-963-2100
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Fax | 813-321-1296
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN203735
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN203735
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License Number State | MA
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