Healthcare Provider Details

I. General information

NPI: 1609202399
Provider Name (Legal Business Name): MEREDITH ANNE GRZYBOWSKI MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5838 HARBOUR VIEW BLVD SUITE 240
SUFFOLK VA
23435-2663
US

IV. Provider business mailing address

5839 HARBOUR VIEW BLVD #200
SUDDOLK VA
23435
US

V. Phone/Fax

Practice location:
  • Phone: 757-483-3030
  • Fax:
Mailing address:
  • Phone: 757-483-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024170884
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: