Individual
CARYN R GRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1350 FLEMINGSBURG RD, MOREHEAD, KY 40351-1810
(859) 263-5140
(859) 263-5141
Mailing address
3480 YORKSHIRE MEDICAL PARK, LEXINGTON, KY 40509-1886
(859) 263-5140
(859) 263-5141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1923
KY
363AS0400X
Surgical Physician Assistant
TC294
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100396660
—
KY
01
—
PA1923
STATE LICENSE
KY
Enumeration date
09/29/2014
Last updated
06/22/2022
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