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NPI Code Detail

MEDICARE: MS. DEANNA CAROLE GRENIER-MULLINS N.P.

MEDICARE: MS. DEANNA CAROLE GRENIER-MULLINS N.P.
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
1363LA2200XAdult Health Nurse PractitionerRN 502181, NPF 7829CA

General Provider Information

NPI Number : 1558372292
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEANNA CAROLE GRENIER-MULLINS N.P.
Provider Business Mailing Address
First Line : 5855 SILVER CREEK VALLEY RD # 171-3N5
Second Line :
City : SAN JOSE
State : CA
Zip : 95138-1059
Country : US
Telephone Number : 408-574-9173
Fax Number : 650-858-8905
Provider Business Practice Location Address
First Line : 3801 MIRANDA AVE
Second Line : HBPC-SAN JOSE CLINIC
City : PALO ALTO
State : CA
Zip : 94304-1207
Country : US
Telephone Number : 408-363-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 03/07/2023

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