Individual
THERESA E RAPHAEL-GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27599-0001
(919) 966-4131
Mailing address
143 W FRANKLIN ST, CHAPEL HILL, NC 27516-2539
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
125601
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6004060
—
NC
01
—
P00348593
NC RAILROAD MEDICARE
NC
Enumeration date
10/10/2006
Last updated
08/05/2008
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