| Mr Gerome Alonzo Grivas, NP | |
| 
					3175 Lenox Park Blvd Ste 412, Memphis, TN 38115-4256  | |
| (901) 273-2369 | |
| Not Available | 
| Full Name | Mr Gerome Alonzo Grivas | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner - Psychiatric/mental Health | 
| Location | 3175 Lenox Park Blvd Ste 412, Memphis, Tennessee | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497883607 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 17743 (California) | Secondary | 
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 12129 (Tennessee) | Primary | 
| Entity Name | Permanente Medical Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mr Gerome Alonzo Grivas, NP 1118 Continentals Way, Belmont, CA 94002-3119 Ph: (650) 270-5393  | Mr Gerome Alonzo Grivas, NP 3175 Lenox Park Blvd Ste 412, Memphis, TN 38115-4256 Ph: (901) 273-2369  | 
Michelle L Rush, MSN, APRN, BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 880 Madison Ave, Memphis, TN 38103 Phone: 901-545-6969 Fax: 901-545-1711  | |
Mrs. Leslie Rhodes, PNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 51 N Dunlap St Ste 100, Memphis, TN 38105 Phone: 901-287-7337 Fax: 901-937-6681  | |
Gwendolyn Watson, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 201 Poplar Ave, Memphis, TN 38103 Phone: 901-545-2445  | |
Barbara A Overbey, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 825 Ridge Lake Blvd, Memphis, TN 38120 Phone: 901-685-2200 Fax: 901-259-2715  | |
Miss Jennifer Elaine Roemer, CPNP-AC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 262 Danny Thomas Pl, Memphis, TN 38105 Phone: 901-595-3300  | |
Florida Allen, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3362 S 3rd St, Memphis, TN 38109 Phone: 901-701-2510 Fax: 901-260-8598  | |
Mrs. Sarah Michelle Wredling, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4066 Summer Ave, Memphis, TN 38122 Phone: 901-452-7391  |