Individual
LAURA L LEE GRIBBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
W14034 MELLVILLE STREET, ENGADINE, MI 49827
(906) 477-6066
(906) 477-1052
Mailing address
502 W HARRIE ST, NEWBERRY, MI 49868-1209
(906) 293-9200
(906) 293-9285
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704169020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4569556
—
MI
01
—
500870240
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
09/11/2006
Last updated
10/19/2016
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