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General NPI Number Information
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NPI Number | 1477375780
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Entity Type | Organization
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Legal Business Name | JESSICA GRANATA DNP APRN INC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1166 E BLUE HERON BLVD
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-4738
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Country | US
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Telephone | 561-448-1665
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Fax | 321-616-7676
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Provider Business Mailing Address
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Address Line | 1166 E BLUE HERON BLVD
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-4738
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Country | US
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Telephone | 561-448-1665
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Fax | 321-616-7676
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA GRANATA
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Credential | DNP, APRN
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Telephone | 561-448-1665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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