Individual
JESSICA NICOLE GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, WHNP
Contact information
Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 351-4878
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209025601
IL
363LW0102X
Women's Health Nurse Practitioner
Primary
209025601
IL
Other
Enumeration date
09/15/2022
Last updated
10/01/2025
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