Provider Demographics
NPI:1720535834
Name:GRANETT, EMMILY (MS, CRNA)
Entity type:Individual
Prefix:
First Name:EMMILY
Middle Name:
Last Name:GRANETT
Suffix:
Gender:
Credentials:MS, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11990 E TUSCOLA RD
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-9770
Mailing Address - Country:US
Mailing Address - Phone:989-737-0694
Mailing Address - Fax:
Practice Address - Street 1:11990 E TUSCOLA RD
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-9770
Practice Address - Country:US
Practice Address - Phone:989-737-0694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704279603367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered