Provider Demographics
NPI:1629366265
Name:GRANARA, CAMELLA (FNP-BC, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:CAMELLA
Middle Name:
Last Name:GRANARA
Suffix:
Gender:
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 ELM ST STE 107
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2415
Mailing Address - Country:US
Mailing Address - Phone:617-500-5767
Mailing Address - Fax:617-415-2708
Practice Address - Street 1:21 GREEN ST STE 2
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4000
Practice Address - Country:US
Practice Address - Phone:603-225-2985
Practice Address - Fax:603-225-6160
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH041265-23363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily