Individual
KELLY GRIGORYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
5025 J ST STE 206, SACRAMENTO, CA 95819-3839
(916) 668-7164
Mailing address
4128 STOWE WAY, SACRAMENTO, CA 95864-6058
(978) 866-0674
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95015011
CA
Other
Enumeration date
11/21/2020
Last updated
11/21/2020
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