Provider Demographics
NPI:1164187829
Name:GRIGSBY, DEBORAH LOUISE (MCPCD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LOUISE
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:MCPCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:CASTLE HAYNE
Mailing Address - State:NC
Mailing Address - Zip Code:28429-5412
Mailing Address - Country:US
Mailing Address - Phone:910-685-4494
Mailing Address - Fax:
Practice Address - Street 1:3119 MEMORY LN
Practice Address - Street 2:
Practice Address - City:CASTLE HAYNE
Practice Address - State:NC
Practice Address - Zip Code:28429-5412
Practice Address - Country:US
Practice Address - Phone:910-685-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date: