Individual
BEVERLY GRISWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2301 N DR MARTIN LUTHER KING JR BLVD, CLOVIS, NM 88101-9401
(575) 762-4455
Mailing address
1742 COUNTY ROAD 5, BOVINA, TX 79009-4011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1111103
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
72528
NM
Other
Enumeration date
02/21/2023
Last updated
05/19/2023
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