Provider Demographics
NPI:1134916174
Name:GRIGSBY, EMILY (PMHNP BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GRIGSBY
Suffix:
Gender:
Credentials:PMHNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6007 NEWPORT LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-7684
Mailing Address - Country:US
Mailing Address - Phone:301-758-0051
Mailing Address - Fax:
Practice Address - Street 1:6007 NEWPORT LN
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-7684
Practice Address - Country:US
Practice Address - Phone:301-758-0051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204611363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty