Individual provider · Type 1 NPI
Mark Jason Granada, AGNP
Gerontology Nurse Practitioner · Merced, CA
NPI number
1386353761
Active
Practice location
857 W Childs Ave
Merced, CA 95341-6862
Mailing address
1910 Customer Care Way
Atwater, CA 95301-5167
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 95024681 (CA) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | 95024681 (CA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1386353761
Mark Jason Granada, AGNP's National Provider Identifier is 1386353761, issued on Nov 15, 2022. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Merced, CA. The record was last updated on Jul 30, 2024.