Individual
DEANA GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15 CRESTVIEW PLZ, JACKSONVILLE, AR 72076-4341
(501) 982-5000
(501) 982-5007
Mailing address
4508 STADIUM BLVD, JONESBORO, AR 72404-9675
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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