Individual
ANNA GRIZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
R114638
MD
367A00000X
Advanced Practice Midwife
Primary
RN59767
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010
BCBS
—
01
—
1482782
AETNA PPO
—
05
—
170550400
—
MD
01
—
3142241
MAMSI
—
01
—
612176400
FEDERAL WORKMANS COMP
—
01
—
64075
AMERIGROUP
—
01
—
68596012
BCBS
—
Enumeration date
10/03/2006
Last updated
11/30/2011
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