Individual
TERESA GRIZZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
350 HOSPITAL DR, MACON, GA 31217-3838
(478) 765-7000
Mailing address
108 ELMDALE DR, BONAIRE, GA 31005-4462
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN201808
GA
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN201808
GA
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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