Individual
COURTNEY ANN GRIMES
Active
Individual
COURTNEY ANN GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
645445
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F309184-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10312015
—
NY
Enumeration date
04/04/2019
Last updated
08/20/2019
Update your record
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