Provider Demographics
NPI:1083450191
Name:GRIGSBY, LESHA SUMMER (FNP-C)
Entity type:Individual
Prefix:
First Name:LESHA
Middle Name:SUMMER
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 W BARCELONA LN
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-2601
Mailing Address - Country:US
Mailing Address - Phone:559-346-9234
Mailing Address - Fax:
Practice Address - Street 1:41 W BARCELONA LN
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-2601
Practice Address - Country:US
Practice Address - Phone:559-346-9234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily