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NPI Code Detail

MEDICARE: MRS. DANIELLA DEONA GRANTHAM WHNP

MEDICARE: MRS. DANIELLA DEONA GRANTHAM WHNP
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
1363LW0102XWomen's Health Nurse Practitioner559826TX
2363LW0102XWomen's Health Nurse PractitionerAP108955TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801899349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANIELLA DEONA GRANTHAM WHNP
Provider Business Mailing Address
First Line : 214 SOLAR WAY
Second Line :
City : DENTON
State : TX
Zip : 76207-2204
Country : US
Telephone Number : 940-391-0235
Fax Number :
Provider Business Practice Location Address
First Line : 7121 S PADRE ISLAND DR
Second Line : STE 200
City : CORPUS CHRISTI
State : TX
Zip : 78412-4940
Country : US
Telephone Number : 361-993-6000
Fax Number : 361-993-3676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2005
Last Update Date : 05/18/2021

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