| NPI | 1245857796 |
|---|---|
| Former Name | HEATHER DAWN GRISSOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: IN 71010032A) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: IN 28217718A) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-09 |