Provider Demographics
NPI:1396994190
Name:GRIZZLE, DONNA MARIE (RN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:GRIZZLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 TRUMBO RD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6684
Mailing Address - Country:US
Mailing Address - Phone:305-296-5628
Mailing Address - Fax:
Practice Address - Street 1:1105 LEON ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3541
Practice Address - Country:US
Practice Address - Phone:305-296-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1835582163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse