Individual
GRISSA SANDOY HERMOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
216 KENNEDY ST, CLYDE, TX 79510-4406
(325) 386-5103
Mailing address
216 KENNEDY ST, CLYDE, TX 79510-4406
(325) 386-5103
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1132704
TX
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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