Individual
KATHY GRIESEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 COLE AVE, BISBEE, AZ 85603-1327
(520) 432-6481
(520) 432-2098
Mailing address
101 COLE AVENUE, BISBEE, AZ 85603
(520) 366-0300
(520) 432-2098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2045
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
441486
—
AZ
Enumeration date
09/22/2005
Last updated
08/12/2022
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