MEDICARE: ASHELY GRIZZARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	90962	TN

General Provider Information

NPI Number	:	1255208872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHELY GRIZZARD

Provider Business Mailing Address
First Line	:	1420 DONELSON PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-2927
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 DONELSON PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-2927
Country	:	US
Telephone Number	:	629-895-5376
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	10/20/2025

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Directions to “ ASHELY GRIZZARD ” Practice Location

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