Provider Demographics
NPI:1427336767
Name:MCGRANAHAN, KELLY LYNN (CNP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:LYNN
Last Name:MCGRANAHAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:LYNN
Other - Last Name:MALENSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 E MARKET ST
Mailing Address - Street 2:STE. 3-E
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1619
Mailing Address - Country:US
Mailing Address - Phone:330-379-5100
Mailing Address - Fax:330-379-5177
Practice Address - Street 1:525 E MARKET ST
Practice Address - Street 2:STE. 3-E
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1619
Practice Address - Country:US
Practice Address - Phone:330-379-5100
Practice Address - Fax:330-379-5177
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12526-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health