Individual
DR. BRENT ALAN GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
3037 CORDER DR, CORINTH, MS 38834-6216
(662) 284-8565
(662) 594-8366
Mailing address
PO BOX 1740, CORINTH, MS 38835-1740
(662) 284-8565
(662) 594-8366
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
16792
TN
363L00000X
Nurse Practitioner
Primary
810467
MS
363LF0000X
Family Nurse Practitioner
APN0000016792
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004252075
—
MS
Enumeration date
07/07/2005
Last updated
06/27/2023
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