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1932984937
NICOLE GRISSOM
CERES, CA
NPI
1932984937
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: CA 732242)
Enumeration Date
2023-08-28
Last Update Date
2023-08-28
Business Address
NICOLE GRISSOM
3016 GLEN PARK WAY
CERES, CA 95307-2928
Phone number: 541-778-3099
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Mailing Address
NICOLE GRISSOM
3016 GLEN PARK WAY
CERES, CA 95307-2928
Phone number: 541-778-3099
Copy
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