Individual
MISS TASHA GRISSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14502 W MEEKER BLVD, SUN CITY WEST, AZ 85375-5282
(623) 524-8767
Mailing address
8430 W RILEY RD, TOLLESON, AZ 85353-3683
(623) 478-5280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-00285
NC
363A00000X
Physician Assistant
005537
GA
363A00000X
Physician Assistant
5752
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
03/15/2007
Last updated
11/26/2014
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