| NPI | 1104622729 |
|---|---|
| Former Name | JESSICA CARRIE GRISHABER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11037851) |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-03-31 |