Individual
MS. LISA M GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
1501 N CAMPBELL AVENUE, TUCSON, AZ 85724
(520) 626-6627
(520) 626-5009
Mailing address
2701 E ELVIRA RD, TUCSON, AZ 85756-7214
(520) 626-6627
(520) 626-5009
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
AP2222
AZ
363LN0000X
Neonatal Nurse Practitioner
RN113958
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207375
—
AZ
Enumeration date
09/27/2006
Last updated
05/22/2013
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