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NPI Code Detail

MEDICARE: RAUL E GRANADOS NP

MEDICARE: RAUL E GRANADOS 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
1363LA2100XAcute Care Nurse Practitioner228701AZ

General Provider Information

NPI Number : 1902757602
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAUL E GRANADOS NP
Provider Business Mailing Address
First Line : 2228 W ALASKA AVE
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-8496
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 N BEAVER ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3118
Country : US
Telephone Number : 520-235-4693
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2026
Last Update Date : 02/11/2026

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Directions to “ RAUL E GRANADOS NP” Practice Location

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