Grisham, Shandy

Grisham, Shandy is an individual health care provider with primary practice located at 800 W Magnolia Ave , Fort Worth TX 76104-4611. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Grisham, Shandy can be contacted via phone (817) 759-7000.

Contact Information

Primary practice address
800 W Magnolia Ave Fort Worth TX 76104-4611
Phone: (817) 759-7000
Fax: (817) 759-7027
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 724029 Texas

Profile Details

NPI number 1073566964
LBN Legal business name Grisham, Shandy
Credentials RN, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Feb 6th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073566964 NPPES
Texas MEDICAID 1788028-02
Texas Other 8N9862
Texas MEDICAID 178802805

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