Karin Elaine Grantham, APRN
Nurse Practitioner, Family in Tyler, TX. Individual provider (NPI-1).
NPI number1164055950
StatusActive
Last updated in NPPESApr 21, 2025
Details
- NPI
- 1164055950
- Entity type
- Individual (NPI-1)
- Name
- Karin Elaine Grantham
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 20, 2020
- Certification date
- Apr 21, 2025
- Last updated
- Apr 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 1044084 | TX | Yes |
| 163W00000X | Registered Nurse | 533441 | TX |
Practice location
409 W Ferguson StTyler, TX 75702-5632
Phone 903-596-8353
Mailing address
16144 Rocky Ridge RdBullard, TX 75757-9733
Phone 903-747-2205
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