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Individual

MIKI N GRIMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
64-1035 MAMALAHOA HWY STE K, KAMUELA, HI 96743-8440
(808) 885-9647
(808) 885-9647
Mailing address
64-1035 MAMALAHOA HWY, SUITE K, KAMUELA, HI 96738
(808) 885-9647
(808) 885-9647

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN34158
HI
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN258
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
52191501
HI
Enumeration date
10/12/2006
Last updated
07/21/2022
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