Provider Demographics
NPI:1922735596
Name:GRAMSE, COLTON E (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:COLTON
Middle Name:E
Last Name:GRAMSE
Suffix:
Gender:M
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 N SAMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-3230
Mailing Address - Country:US
Mailing Address - Phone:731-607-9540
Mailing Address - Fax:
Practice Address - Street 1:1038 N SAMPSON AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3230
Practice Address - Country:US
Practice Address - Phone:731-607-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022030564363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health