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Individual

ASHLEY GRIMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4805
Mailing address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4805

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN183224
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN183224
NURSING LICENSE
GA
Enumeration date
08/06/2014
Last updated
08/06/2014
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