Individual
JACOB GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3800 VENETIAN WAY, NEWBURGH, IN 47630-8257
(812) 477-6103
(812) 469-3285
Mailing address
3800 VENETIAN WAY, NEWBURGH, IN 47630-8257
(812) 477-6103
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71015844A
IN
Other
Enumeration date
10/09/2024
Last updated
05/13/2025
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