Grissom, Bradley

Grissom, Bradley is an individual health care provider with primary practice located at 2300 N. Vermilion Avenue Medical Sub-Specialties, Danville IL 61832. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Grissom, Bradley can be contacted via phone (217) 554-1700.

Contact Information

Primary practice address
2300 N. Vermilion Avenue Medical Sub-Specialties Danville IL 61832
Phone: (217) 554-1700
Fax: (217) 554-1704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209005691 Illinois

Profile Details

NPI number 1891830402
LBN Legal business name Grissom, Bradley
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Dec 27th, 2010 - about 16 years ago

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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