Individual
JUSTIN GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AG-ACNP, FNP
Contact information
Practice address
3210 GOTHIC PL, COLORADO SPRINGS, CO 80917-4323
(719) 210-5633
Mailing address
3210 GOTHIC PL, COLORADO SPRINGS, CO 80917-4323
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.0996720-NP
CO
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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