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NPI Code Detail

MEDICARE: AZURE GRISSOM APRN, FNP-C

MEDICARE: AZURE GRISSOM APRN, FNP-C
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
1363LF0000XFamily Nurse PractitionerAPN.0994256-NPCO

General Provider Information

NPI Number : 1841766268
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZURE GRISSOM APRN, FNP-C
Provider Business Mailing Address
First Line : 2350 MEADOWS BLVD
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80109-8405
Country : US
Telephone Number : 720-455-0489
Fax Number : 720-455-0471
Provider Business Practice Location Address
First Line : 2350 MEADOWS BLVD
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80109-8405
Country : US
Telephone Number : 720-455-0489
Fax Number : 720-455-0471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 04/13/2026

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Directions to “ AZURE GRISSOM APRN, FNP-C” Practice Location

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