| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ANGELICA MARIE GRANILLO | 1477285880 | 2022-06-26 |
Angelica Marie Granillo is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1477285880. Registration indicates Angelica Marie Granillo is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Angelica Marie Granillo FNP-C |
| Practice Office Address | 5605 E RIVER RD STE 219 TUCSON, AZ US |
| Practice Office Telephone | 5203144275 |
| Mailing Address | 5605 E RIVER RD STE 219 TUCSON, AZ 857501900 US |
| Business Telephone | 5203144275 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 276426
AZ |