NPI | 1194434621 |
---|---|
Former Name | KRISTY LYNN GRISHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 32789) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023323) |
Enumeration Date | 2022-11-23 |
Last Update Date | 2023-08-22 |