Most Relevant Information
Provider Data
| NPI Number: | 1003424128 |
| Provider Name: | KELLY P GRENNER ARNP-FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | AP61085959 |
Most Important Dates
| Enumeration Date: | 07/14/2020 |
| Last Updated: | 04/20/2021 |
Provider Practice Location
10025 NE 186TH ST
BOTHELL
WA
980113839
Practice Location Phone/Fax
| Phone: | 4254869131 |
| Fax: | 4254869490 |
Provider Mailing Location
22850 NE 8TH ST STE 103
SAMMAMISH
WA
980747256
Provider Mailing Phone/Fax
| Phone: | 4258980305 |
| Fax: | 4258988825 |