Individual
MRS. LINDA CAROL GRISSOM
Active
Individual
MRS. LINDA CAROL GRISSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN040340
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP5963
AZ
Other
Enumeration date
09/01/2005
Last updated
07/23/2026
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