DR. AMBER NICOLE GRISSOM DNP AGNP-C NPI 1689177867

NPI Information

NPI: 1689177867
Provider Name: DR. AMBER NICOLE GRISSOM, DNP, AGNP-C
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
302 HUSSON AVE STE 1
BANGOR, ME
ZIP 04401
Phone: (207) 947-6141
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DR. Amber Nicole Grissom, DNP, AGNP-C is a primary care nurse practitioner in Bangor, ME with 7 years of experience. DR. Amber Nicole Grissom, DNP, AGNP-C NPI is 1689177867. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

302 HUSSON AVE STE 1
BANGOR, ME
ZIP 04401-373
Phone: (207) 947-6141
Fax: (207) 947-6720

The NPI 1689177867 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/14/2018 and was last updated on 11/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	CNP201287	MAINE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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