Individual
CHARLA GAYLE GRANBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1005 W RALPH HALL PKWY, ROCKWALL, TX 75032-6658
(972) 771-9081
(972) 772-7102
Mailing address
1005 W RALPH HALL PKWY, SUITE 201, ROCKWALL, TX 75032-6658
(972) 771-9081
(972) 772-7102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
246073
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246073
NURSE PRACTIONER
TX
Enumeration date
02/22/2007
Last updated
03/31/2022
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