Individual
JESSICA MCKENZIE GRIMSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
276 N RON MCNAIR BLVD, LAKE CITY, SC 29560-2462
(843) 394-5471
Mailing address
PO BOX 23467, NEW YORK, NY 10087-3467
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19962
SC
Other
Enumeration date
02/01/2016
Last updated
10/11/2022
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