JENNIFER GRISHAM (NPI# 1790397586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790397586 |
| Entity Type | Individual |
| Full Name | JENNIFER GRISHAM |
| Credential | FNP-C |
| Practice Address |
2551 Greenwood Rd Ste 410 Shreveport LA 71103-3989 |
| Mailing Address |
9525 Stevens Rd Shreveport LA 71106-7530 |
| Practice Telephone | 3186212929 |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2020-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
213829 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427288422 | Jennifer P Grisham | Nurse Practitioner | 3740 Ocoee Place Nw, Ste 101, Cleveland, TN 37312-5635 | 2009-07-24 |
| 1952406589 | Jennifer L Grisham | Pediatrics | 1573 Medical Park Cir, Tupelo, MS 38801-6580 | 2006-09-14 |
| Street Address |
2551 GREENWOOD RD STE 410 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184687212 | Huan Q Le | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2006-04-10 |
| 1801328034 | Mohammad-hesam Akbarian-tefaghi | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2017-03-28 |
| 1063876068 | Derek Rey Munoz | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103 | 2016-04-06 |
| 1700273612 | Michael Broadwell | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2015-04-17 |
| 1659768588 | Brenden Brunner | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2015-04-17 |
| 1134516172 | Kurtis Kostan | Hospitalist | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2015-04-16 |
| 1437579455 | Jared Mcfarlin | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2014-04-17 |
| 1063831352 | David M. Hudson | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2014-04-15 |
| 1861659062 | Matthew Frank | Internal Medicine | 2551 Greenwood Rd Ste 410, Shreveport, LA 71103-3989 | 2008-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841806775 | Shelia M Reliford | Nurse Practitioner | 3928 Balcom St, Shreveport, LA 71109-5004 | 2020-09-16 |
| 1801407325 | Mariagoretti Lumnwi Niba | Nurse Practitioner | 1535 River Parkway Blvd Apt 708, Shreveport, LA 71104-1809 | 2020-08-10 |
| 1437768447 | Sheena Renaye Youngblood | Nurse Practitioner | 1453 E Bert Kouns Industrial Loop Ste 112, Shreveport, LA 71105-6810 | 2020-07-26 |
| 1285265397 | Karen Elizabeth Jordan | Nurse Practitioner | 172 Southfield Rd, Shreveport, LA 71105-3721 | 2020-01-28 |
| 1235776709 | Malene Nilaja Coleman | Nurse Practitioner | 1811 E Bert Kouns Industrial Loop Unit 210, Shreveport, LA 71105-5740 | 2019-12-04 |
| 1417504093 | Roberto Rodriquez Monsanto II | Nurse Practitioner | 3724 Baxter St, Shreveport, LA 71109-7402 | 2019-08-20 |
| 1275188757 | Sara Vergis | Nurse Practitioner | 10453 Keysburg Ct, Shreveport, LA 71106-7785 | 2019-08-02 |
| 1457912800 | Ema-chanel Johnson | Nurse Practitioner | 8219 Spring Valley Cir, Shreveport, LA 71107-8609 | 2019-06-26 |
| 1083170666 | Vanisha Faye Williams | Nurse Practitioner | 8857 Hedges Dr, Shreveport, LA 71118-2008 | 2019-02-19 |
| 1700366655 | Wendy King | Nurse Practitioner | 3060 Duncan Dr, Shreveport, LA 71119-2302 | 2018-08-20 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on JENNIFER GRISHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.