STEPHANIE ALVERA GRANNEMAN NURSE PRACTITIONER NPI 1114008281

NPI Information

  • NPI: 1114008281
  • Provider Name: STEPHANIE ALVERA GRANNEMAN, NURSE PRACTITIONER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 210 N MARKET ST
    MILAN, MO
    ZIP 63556
  • Phone: (660) 265-4456

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NPI Details

Stephanie Alvera Granneman, NURSE PRACTITIONER is a family nurse practitioner in Milan, MO. Stephanie Alvera Granneman, NURSE PRACTITIONER NPI is 1114008281. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

210 N MARKET ST
MILAN, MO
ZIP 63556
Phone: (660) 265-4456
Fax: (660) 265-4627

The NPI 1114008281 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 3/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyRN086431MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1S18332MEDICARE UPINMISSOURI
2263834MEDICARE ID-TYPE UNSPECIFIEDMISSOURIRURAL HEALTH CLINIC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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