Provider Demographics
NPI:1386709830
Name:GRIBBLE, ANITA JAMES (PA-C)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:JAMES
Last Name:GRIBBLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-9600
Mailing Address - Country:US
Mailing Address - Phone:828-413-7105
Mailing Address - Fax:866-888-8770
Practice Address - Street 1:2810 16TH ST NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-9600
Practice Address - Country:US
Practice Address - Phone:828-324-0359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101793363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant