# L C GRISSOM AND ASSOCIATES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033280359
- **Authorized official:** LINDA CAROL GRISSOM N.P. (NURSE PRACTITIONER)
- **Authorized official phone:** (480) 775-8811

## Contact information

- **Practice address:** 1600 W CHANDLER BLVD, STE. 250, CHANDLER, AZ 85224-6153
- **Practice address phone:** (480) 775-8811
- **Practice address fax:** (480) 775-8866
- **Mailing address:** 1600 W CHANDLER BLVD, STE. 250, CHANDLER, AZ 85224-6153
- **Mailing address phone:** (480) 775-8811
- **Mailing address fax:** (480) 775-8866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RN030340 | AZ | Yes |

## Other

- **Enumeration date:** 11/10/2006
- **Last updated:** 08/22/2020