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Individual

JOHANNA MARIE GRASSHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CDE, BC-ADM, CNP

Contact information

Practice address
1515 EUBANK BLVD SE BLDG 832, ALBUQUERQUE, NM 87123-3453
(505) 844-4237
Mailing address
1515 EUBANK BLVD SE BLDG 832, ALBUQUERQUE, NM 87123-3453
(505) 844-4237

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R49987
NM
163WD0400X
Diabetes Educator Registered Nurse
2091-0361
NM
363L00000X
Nurse Practitioner
Primary
56889
NM

Other

Enumeration date
07/11/2012
Last updated
07/11/2019
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