| Doctor Name: | JAMIE ROSE GHRIGSBY |
| NPI Number: | 1093039695 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 1-107147 |
| Business Practice Address: | 122 Medical Cir Moulton, AL - 356501221 |
| Business Phone Number: | 2564103544 |
| Business Fax Number: | 2564103644 |
| Mailing Address: | 122 Medical Cir, MOULTON |
| State: | AL |
| Postal Code: | 356501221 |
| Phone Number: | 2563500906 |
| Fax Number: | 2564103644 |
| NPI Enumeration Date: | 03/25/2010 |
| NPI Last Update Date: | 02/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 1-107147 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |