Individual provider · Type 1 NPI

Jacob Grisham, FNP

Family Nurse Practitioner · Newburgh, IN

NPI number 1417776196 Active

Practice location

3800 Venetian Way
Newburgh, IN 47630-8257

Fax (812) 469-3285

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X71015844A (IN)

Family Nurse Practitioner: Definition to come...

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About NPI 1417776196

Jacob Grisham, FNP's National Provider Identifier is 1417776196, issued on Oct 9, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Newburgh, IN. The record was last updated on May 13, 2025.