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Individual

LAURA A GRIMM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN,BC,PNP

Contact information

Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3593
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3593

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
088365
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100255050A
KS
05
428019707
MO
Enumeration date
04/25/2006
Last updated
06/30/2015
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