Healthcare Provider Details

I. General information

NPI: 1861215212
Provider Name (Legal Business Name): ABIGAIL GRIZZLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U.S. NAVAL HOSPITAL, OKINAWA, CAMP FOSTER
FPO AP
96362
JP

IV. Provider business mailing address

U.S. NAVAL HOSPITAL, OKINAWA, CAMP FOSTER
FPO AP
96362
JP

V. Phone/Fax

Practice location:
  • Phone: 614-332-2418
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN.382721
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: