Provider Demographics
NPI:1093039695
Name:GHRIGSBY, JAMIE ROSE (CNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ROSE
Last Name:GHRIGSBY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:MOULTON
Mailing Address - State:AL
Mailing Address - Zip Code:35650-1221
Mailing Address - Country:US
Mailing Address - Phone:256-350-0906
Mailing Address - Fax:256-410-3644
Practice Address - Street 1:122 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650-1221
Practice Address - Country:US
Practice Address - Phone:256-410-3544
Practice Address - Fax:256-410-3644
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-107147363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care