Individual provider · Type 1 NPI
Fallon Chanel Granger, NURSE PRACTITIONER
Family Nurse Practitioner · Jacksonville, FL
NPI number
1518630243
Active
Practice location
655 W 8th St
Jacksonville, FL 32209-6511
Mailing address
95217 Orchid Blossom Trl
Fernandina Beach, FL 32034-0182
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | APRN11013960 (FL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1518630243
Fallon Chanel Granger, NURSE PRACTITIONER's National Provider Identifier is 1518630243, issued on Jul 28, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Jacksonville, FL. The record was last updated on Dec 15, 2021.