Shandy Grisham is a Family in Fort Worth, Texas. Shandy Grisham practices all healthcare services and medical treatments related to Family. The NPI Number for Shandy Grisham is 1073566964. The last update date is 2020-12-28.
Shandy Grisham's current location address is 800 W Magnolia Ave, Fort Worth, Texas. You can contact this provider via phone number 8177597000 and fax number 8177597027. The mailing address for Shandy Grisham is 800 W Magnolia Ave, Fort Worth, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shandy Grisham |
|---|---|
| Address | 800 W Magnolia Ave, Fort Worth, Texas |
| Phone Number | 8177597000 |
| Fax Number | 8177597027 |
| Sole Proprietor | N |
| Credentials | RN, FNP |
NPI Number Detail
| NPI Number | 1073566964 |
|---|---|
| Provider Enumeration Date | 2006-05-19 |
| Last Updated Date | 2020-12-28 |
Provider Mailing Address Detail
| Address | 800 W Magnolia Ave |
|---|---|
| City | Fort Worth |
| State | Texas (TX) |
| Post Code | 761044611 |
| Phone Number | 8177597000 |
| Fax Number | 8177597027 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 724029 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 178802805 | TX | -- | |
| 8N9862 | BCBS | ||
| 1788028-02 | TX | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Shandy Grisham by the Centers for Medicare & Medicaid Services?
The Shandy Grisham has been issued the NPI (National Provider Identifier) 1073566964 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Shandy Grisham?
The Shandy Grisham is physically situated at 800 W Magnolia Ave, in the city of Fort Worth, state of TX, with the postal code 761044611.
What is Shandy Grisham's area of expertise and its corresponding taxonomy classification?
The Shandy Grisham's field of specialization is Family, and it falls under the taxonomy code 363Lf0000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1073566964 to Shandy Grisham?
The Centers for Medicare & Medicaid Services assigned the 1073566964 to Shandy Grisham on 2006-05-19.
When was the information pertaining to Shandy Grisham most recently updated or revised?
The details related to Shandy Grisham, including its address, specialty, and other relevant information, were last updated or revised on 2020-12-28.