Individual
DR. TARA JILL GRIMALDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20930 W 151ST, OLATHE, KS 66061
(913) 782-2525
(913) 782-9307
Mailing address
20930 W 151ST, OLATHE, KS 66061
(913) 782-2525
(913) 782-9307
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
04-32569
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200441540A
—
KS
Enumeration date
06/13/2007
Last updated
11/07/2011
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