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Individual

KENNETH GRIGSBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1421 N 7TH ST, TERRE HAUTE, IN 47807-1005
(812) 231-4608
Mailing address
2001 OAK CREEK RD APT D128, RIVER RIDGE, LA 70123-5837

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
514266
IN

Other

Enumeration date
06/10/2016
Last updated
06/10/2016
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