Theresa Grimes FNP-BC

NPI 1912910910 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1912910910
Gender Female
Enumeration Date 08/14/2006
Last Updated 02/04/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
75 N COUNTRY RD
PORT JEFFERSON NY, 11777-2119, US
Phone (631) 476-2847
Fax
Business Location
12 MONITOR CT
CORAM NY, 11727-1634, US
Phone (631) 476-2734
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State New York
License Number F332400-1
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According to our database, Theresa Grimes FNP-BC NPI is 1912910910, taxonomy code is 363LF0000X and license number is F332400-1, license state is located at New York. Theresa Grimes FNP-BC physically located at 75 N Country Rd, Port Jefferson NY, 11777-2119. NPI Number Theresa Grimes FNP-BC has the Individual type.

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1912910910 NPI number is provided on an as is basis without warranty of any kind. 1912910910 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa Grimes FNP-BC are for informational purposes only.