Individual
RHONDA PARKER GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4737 S 209TH WEST AVE, SAND SPRINGS, OK 74063-4656
(918) 408-8151
(918) 745-9750
Mailing address
4808 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 742-2502
(918) 745-9750
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0084504
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200091060A
—
OK
01
—
900522349
MEDICARE GROUP PIN
OK
Enumeration date
07/10/2006
Last updated
04/08/2021
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