Most Relevant Information
Provider Data
| NPI Number: | 1003809708 |
| Provider Name: | CHERYL GRANILLO CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | R53026 |
Most Important Dates
| Enumeration Date: | 08/26/2005 |
| Last Updated: | 08/01/2011 |
Provider Practice Location
125 CHAPARREL BLVD NW
DEMING
NM
880308629
Practice Location Phone/Fax
| Phone: | 5755464800 |
| Fax: | 5755460685 |
Provider Mailing Location
PO BOX 370
HATCH
NM
879370370
Provider Mailing Phone/Fax
| Phone: | 5752673280 |
| Fax: | 5752671747 |