Individual
MRS. LA REA ANN GRIMSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4400 KATIE RIDGE DR, MOORE, OK 73160-6269
(405) 246-6106
Mailing address
4400 KATIE RIDGE DR, MOORE, OK 73160-6269
(405) 246-6106
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0056826
OK
Other
Enumeration date
12/28/2012
Last updated
12/28/2012
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