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Individual

MRS. DANIELLA DEONA GRANTHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP

Contact information

Practice address
7121 S PADRE ISLAND DR, STE 200, CORPUS CHRISTI, TX 78412-4940
(361) 993-6000
(361) 993-3676
Mailing address
214 SOLAR WAY, DENTON, TX 76207-2204
(940) 391-0235

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
559826
TX
363LW0102X
Women's Health Nurse Practitioner
Primary
AP108955
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120095808
TX
Enumeration date
05/28/2005
Last updated
05/18/2021
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