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General NPI Number Information
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NPI Number | 1629366265
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Entity Type | Individual
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Provider Name | CAMELLA GRANARA FNP-BC, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 21 GREEN ST STE 2
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City | CONCORD
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State | NH
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Zip | 03301-4000
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Country | US
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Telephone | 603-225-2985
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Fax | 603-225-6160
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Provider Business Mailing Address
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Address Line | 51 ELM ST STE 107
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City | LACONIA
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State | NH
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Zip | 03246-2415
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Country | US
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Telephone | 617-500-5767
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Fax | 617-415-2708
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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 | 041265-23
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License Number State | NH
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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 | 041265-23
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License Number State | NH
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