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NPI Code Detail

MEDICARE: MRS. KAYLEIGH LAUREN GRANZELLA NP

MEDICARE: MRS. KAYLEIGH LAUREN GRANZELLA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPN.0999597CO

General Provider Information

NPI Number : 1295595189
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAYLEIGH LAUREN GRANZELLA NP
Provider Business Mailing Address
First Line : 5475 TECH CENTER DR STE 105
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-2336
Country : US
Telephone Number : 719-223-4621
Fax Number :
Provider Business Practice Location Address
First Line : 5475 TECH CENTER DR STE 105
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-2336
Country : US
Telephone Number : 719-223-4621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2024
Last Update Date : 08/13/2025

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