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NPI Code Detail

MEDICARE: PATTI G GRANZIN FNP-C,APRN

MEDICARE: PATTI G GRANZIN FNP-C,APRN
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
1363LF0000XFamily Nurse PractitionerAP01188LA

General Provider Information

NPI Number : 1497792519
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATTI G GRANZIN FNP-C,APRN
Provider Business Mailing Address
First Line : 10101 PARK ROWE AVE STE 200
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-1685
Country : US
Telephone Number : 225-769-2200
Fax Number : 225-768-2185
Provider Business Practice Location Address
First Line : 10101 PARK ROWE AVE STE 200
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-1685
Country : US
Telephone Number : 225-769-2200
Fax Number : 225-768-2185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 07/08/2007

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