Provider Demographics
NPI:1477180487
Name:GRIGUS, SAMANTHA STEVE (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:STEVE
Last Name:GRIGUS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:CHRISTINE
Other - Last Name:STEVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:6224 BELLE GROVE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-5020
Mailing Address - Country:US
Mailing Address - Phone:904-502-5860
Mailing Address - Fax:
Practice Address - Street 1:6224 BELLE GROVE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-5020
Practice Address - Country:US
Practice Address - Phone:904-502-5860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program