Individual
MISS LAURA EILEEN WERKING GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2863 W MURIEL DR, PHOENIX, AZ 85053-1944
(602) 824-9357
Mailing address
2863 W MURIEL DR, PHOENIX, AZ 85053-1944
(602) 824-9357
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AZ2232
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109622
—
AZ
Enumeration date
07/17/2006
Last updated
09/01/2011
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