Individual
KATHLEEN A GRIMM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
23901 LAHSER RD, SOUTHFIELD, MI 48034-6035
(248) 357-3360
(248) 357-0915
Mailing address
6684 MELDRUM RD, FAIR HAVEN, MI 48023-2001
(586) 725-8062
(248) 357-0915
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704114284
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KG114284
BCBSM NUMBER
MI
Enumeration date
06/15/2006
Last updated
07/09/2007
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