Provider Demographics
NPI:1134510670
Name:GRIGG, KAYCE LEIGH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KAYCE
Middle Name:LEIGH
Last Name:GRIGG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7133 RIVERSIDE PKWY
Mailing Address - Street 2:TOTAL HEALTH MEDICAL
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5053
Mailing Address - Country:US
Mailing Address - Phone:918-791-8102
Mailing Address - Fax:
Practice Address - Street 1:7133 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5053
Practice Address - Country:US
Practice Address - Phone:918-794-4652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF1014408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily