Individual
CHRISTAN GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5736 MANCHESTER HWY, MORRISON, TN 37357-7503
(931) 815-3876
Mailing address
PO BOX 640, MCMINNVILLE, TN 37111-0640
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
78125
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78125
LICENSE
TN
Enumeration date
04/12/2018
Last updated
04/12/2018
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