Individual
MRS. CARRIE JEAN GRANBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P, RN,
Contact information
Practice address
2530 HORIZON DR, BURNSVILLE, MN 55337-3091
(651) 209-8640
(651) 209-8690
Mailing address
2530 HORIZON DR, BURNSVILLE, MN 55337-3091
(651) 209-8640
(651) 209-8690
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20111783
MN
363LP2300X
Primary Care Nurse Practitioner
20111783
MN
Other
Enumeration date
04/03/2012
Last updated
10/25/2012
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