Individual
MRS. LINDA CAROL GRISSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3740 E SOUTHERN AVE, SUITE 207, MESA, AZ 85206-2567
(480) 325-0313
(480) 324-0631
Mailing address
3740 E SOUTHERN AVE, SUITE 207, MESA, AZ 85206-2567
(480) 325-0313
(480) 324-0631
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN040340
AZ
Other
Enumeration date
09/01/2005
Last updated
09/21/2010
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