Provider Demographics
NPI:1396576575
Name:GRIZZELL, TOMEEKA DESHAWNN (LVN)
Entity type:Individual
Prefix:MS
First Name:TOMEEKA
Middle Name:DESHAWNN
Last Name:GRIZZELL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66832 3RD ST APT A
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-3798
Mailing Address - Country:US
Mailing Address - Phone:760-676-6653
Mailing Address - Fax:
Practice Address - Street 1:66832 3RD ST
Practice Address - Street 2:UNIT A
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240
Practice Address - Country:UM
Practice Address - Phone:760-676-6653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA242024164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse