Provider Demographics
NPI:1154761443
Name:GRISHAM, KAREN R (DPH)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:R
Last Name:GRISHAM
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 TENNESSEE AVE N
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:TN
Mailing Address - Zip Code:38363-2616
Mailing Address - Country:US
Mailing Address - Phone:731-847-3851
Mailing Address - Fax:
Practice Address - Street 1:501 TENNESSEE AVE N
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-2616
Practice Address - Country:US
Practice Address - Phone:731-847-3851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist