Individual
CHERYL GRANILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
125 CHAPARREL BLVD NW, DEMING, NM 88030-8629
(575) 546-4800
(575) 546-0685
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP01279
NM
363L00000X
Nurse Practitioner
R53026
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53985788
—
NM
Enumeration date
08/26/2005
Last updated
08/01/2011
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