Individual
BONNIE J GRISSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
PALMETTO HEALTH BAPTIST DIABETES EDUCATION, 1333 TAYLOR STREET; SUITE 4-E, COLUMBIA, SC 29201
(803) 296-3956
(803) 296-8908
Mailing address
PALMETTO HEALTH BAPTIST DIABETES EDUCATION, 1333 TAYLOR STREET; SUITE 4-E, COLUMBIA, SC 29201
(803) 296-3956
(803) 296-8908
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
64034
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64034
STATE LICENSE
SC
Enumeration date
07/23/2007
Last updated
07/23/2007
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