Individual provider · Type 1 NPI

Tisha Grissom

Licensed Practical Nurse · Brooklyn, NY

NPI number 1215464862 Active

Practice location

494 Dumont Ave
Brooklyn, NY 11207-5017

Mailing address

22 Chapel St
Brooklyn, NY 11201-1903

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X262906 (NY)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1215464862

Tisha Grissom's National Provider Identifier is 1215464862, issued on May 15, 2017. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Brooklyn, NY. The record was last updated on May 15, 2017.