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General NPI Number Information
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NPI Number | 1518648930
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Entity Type | Individual
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Provider Name | AMY MICHELLE GRISWOLD DNP, AG-ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 601 JOHN ST STE M-460
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City | KALAMAZOO
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State | MI
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Zip | 49007-5355
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Country | US
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Telephone | 269-341-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 7870 96TH ST SE
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City | ALTO
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State | MI
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Zip | 49302-9799
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Country | US
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Telephone | 818-845-9252
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704257727
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License Number State | MI
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