Individual
NANCY E GRIMSRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CPNP
Contact information
Practice address
700 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-6563
Mailing address
700 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-6300
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1083
AK
363LP0200X
Pediatric Nurse Practitioner
R0927633
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081718000
—
MN
Enumeration date
08/20/2006
Last updated
04/21/2011
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