Provider Demographics
NPI:1588678825
Name:GRISHAM, MARGARET ANN (APRN,BC)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:GRISHAM
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:ANN
Other - Last Name:GRISHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:1804 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-4427
Mailing Address - Country:US
Mailing Address - Phone:501-835-0668
Mailing Address - Fax:
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:116P/NLR
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5484
Practice Address - Country:US
Practice Address - Phone:501-257-3468
Practice Address - Fax:501-257-3125
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR11249163WP0809X
ARAPN CNS S01030364SP0809X
AR364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Not Answered364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult