Individual provider · Type 1 NPI

Michael Terrell Grissom, CRNP

Adult Health Nurse Practitioner · Madison, AL

NPI number 1649649138 Active

Practice location

8375 Highway 72 W
Madison, AL 35758-9573

Mailing address

303 Kimberly Ave
Muscle Shoals, AL 35661-3768

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X1-131578 (AL)
Gerontology Nurse Practitioner 363LG0600X1-131578 (AL)
Primary Care Nurse Practitioner 363LP2300X1-131578 (AL)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1649649138

Michael Terrell Grissom, CRNP's National Provider Identifier is 1649649138, issued on Sep 15, 2015. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Madison, AL. The record was last updated on Sep 15, 2015.