Provider Demographics
NPI:1851703003
Name:GRISWOLD DAVIS, LASONYA MICHELLE (APN)
Entity type:Individual
Prefix:MRS
First Name:LASONYA
Middle Name:MICHELLE
Last Name:GRISWOLD DAVIS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6814 PRINCETON PIKE
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-9411
Mailing Address - Country:US
Mailing Address - Phone:870-267-6347
Mailing Address - Fax:
Practice Address - Street 1:HWY 65 & HWY 388
Practice Address - Street 2:
Practice Address - City:GRADY
Practice Address - State:AR
Practice Address - Zip Code:71644-0500
Practice Address - Country:US
Practice Address - Phone:870-850-8673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003883363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner