Individual
EILEEN O'NEIL GRIGUTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
550 S JACKSON ST, 2ND FLOOR, LOUISVILLE, KY 40202-1622
(502) 562-6511
(502) 562-6512
Mailing address
501 E BROADWAY, STE 290, LOUISVILLE, KY 40202-1785
(502) 217-8221
(502) 217-5056
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3333P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200942760
—
IN
01
—
50016607
PASSPORT HEALTH PLAN
KY
01
—
536489
ANTHEM
KY
05
—
7100049340
—
KY
Enumeration date
06/03/2006
Last updated
11/18/2015
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