Healthcare Provider Details

I. General information

NPI: 1578085809
Provider Name (Legal Business Name): PAULA HUTTO GRIGGS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAULA KAY HUTTO

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 05/25/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 JACKSON ST
MONROE LA
71201-7407
US

IV. Provider business mailing address

907 BROWNLEE RD
CALHOUN LA
71225-8266
US

V. Phone/Fax

Practice location:
  • Phone: 318-966-4541
  • Fax:
Mailing address:
  • Phone: 318-381-5025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number09347
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: