Individual
KELLI GRISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6608 MERCY CT STE B, FAIR OAKS, CA 95628-3171
(916) 241-9844
Mailing address
6608 MERCY CT STE B, FAIR OAKS, CA 95628-3171
(916) 241-9844
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95032540
CA
Other
Enumeration date
10/14/2024
Last updated
09/29/2025
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