KENDRA D GRISSOM (NPI# 1487190112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487190112 |
| Entity Type | Individual |
| Full Name | KENDRA D GRISSOM |
| Credential | NP |
| Practice Address |
10777 Highway 412 W Lexington TN 38351-6283 |
| Practice Telephone | 7319685558 |
| Practice Fax Number | 7319685567 |
| Mailing Telephone | (731) 968-5558 |
| Mailing Fax Number | 7319685567 |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
22181 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 19 Security Dr, Jackson, TN 383053626 | 7316649040 | 7316649041 |
| Street Address |
10777 HIGHWAY 412 W |
| City | LEXINGTON |
| State | TN |
| Zip Code | 38351-6283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265932826 | Elizabeth Ann Snider | Nurse Practitioner | 10777 Highway 412 W, Lexington, TN 38351-6283 | 2018-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417594482 | Kevin B Record | Counselor | 844 Natchez Trace Dr, Lexington, TN 38351 | 2019-12-09 |
| 1659627388 | Candace S Willis | Nurse Practitioner | 864 W Church St Ste A, Lexington, TN 38351 | 2012-07-31 |
| 1356650329 | Robert W Spain | Pharmacist | 654 West Church St, Lexington, TN 38351 | 2010-09-24 |
| 1699944819 | Cynthia Williams | Physical Therapy Assistant | 52 First St, Lexington, TN 38351 | 2008-02-21 |
| 1588703615 | Pansy Hayes Davis | Preventive Medicine | 90 Rush St, Lexington, TN 38351 | 2007-02-05 |
| 1467505958 | Tara Hendrix | Nurse Practitioner | 9550 Hwy 412w Suite C, Lexington, TN 38351 | 2007-01-19 |
| 1760532923 | State of Tennessee | Public Health or Welfare | 90 Rush Street, Lexington, TN 38351 | 2007-01-11 |
| 1154402667 | Professional Arts Pharmacy, LLC | Pharmacy | 270 West Church St Suite C, Lexington, TN 38351 | 2006-10-18 |
| 1891881090 | Jones Pharmacy, LLC | Pharmacy | 101 Lexington Plaza, Lexington, TN 38351 | 2006-10-05 |
| 1366453060 | Tommy Wayne Page | Dentist | 104 Lexington Plaza, Lexington, TN 38351 | 2006-08-10 |
| Find all providers in zip 38351 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386194447 | Morgan Chojnacki | Nurse Practitioner | Kentucky Clinic Pediatric High Bmi Clinic, 740 S. Limestone 2nd Floor Wing D, Lexington, KY 40536 | 2016-10-12 |
| 1811374887 | Hannah Lynn Puntney | Nurse Practitioner | 800 Rose St. Ms 235, Lexington, KY 40536 | 2015-04-29 |
| 1508294000 | Kelly Caroline Nelson | Nurse Practitioner | 740 S Limestone Rm J442, Lexington, KY 40536-0001 | 2013-10-18 |
| 1891097580 | Jocelyn Miller Snider | Nurse Practitioner | 1223 S Lake Dr, Lexington, SC 29073-6889 | 2010-12-01 |
| 1467789974 | Amanda Faith Dressman | Nurse Practitioner | 1780 Nicholasville Rd Ste 301, Lexington, KY 40503-1413 | 2009-11-05 |
| 1932378593 | Katherine Elaine Fletcher | Nurse Practitioner | 1135 Red Mile Pl, Lexington, KY 40504-1172 | 2008-02-27 |
| 1578602959 | Kate Mcalister Grap | Nurse Practitioner | 1113 Centre Pkwy, Lexington, KY 40517-3208 | 2007-02-05 |
| 1598804973 | Carol Ennis Martin | Nurse Practitioner | The Kentucky Clinic Wing D J252, 740 S. Limestone, Lexington, KY 40536 | 2007-02-05 |
| 1740350347 | Christina Knox Conley | Nurse Practitioner | 800 Rose St Ste C400, Lexington, KY 40536-1835 | 2006-11-09 |
| 1154374759 | Rhonda Kaye Hiler | Nurse Practitioner | 218 Mandalay Rd, Lexington, KY 40504-1333 | 2006-05-18 |
| Find all providers in LEXINGTON | ||||
Please comment or provide details below to improve the information on KENDRA D GRISSOM.
| 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.