PETER MARK GRANDERSON APN FNP-C NPI 1750660528

NPI Information

  • NPI: 1750660528
  • Provider Name: PETER MARK GRANDERSON, APN, FNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 1500 N MOUNT OLIVE ST
    SUITE 1
    SILOAM SPRINGS, AR
    ZIP 72761
  • Phone: (479) 524-8175

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NPI Details

Peter Mark Granderson, APN, FNP-C is a family nurse practitioner in Siloam Springs, AR. Peter Mark Granderson, APN, FNP-C NPI is 1750660528. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1500 N MOUNT OLIVE ST
SUITE 1
SILOAM SPRINGS, AR
ZIP 72761-509
Phone: (479) 524-8175
Fax: (479) 524-8176

The enumeration date for this NPI number is 8/11/2011 and was last updated on 9/23/2016.

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 PractitionerFamilyA03579ARKANSASYes

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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