Individual
LILLAH GRINNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2600 E 18TH ST, CHEYENNE, WY 82001-5511
(307) 634-2273
Mailing address
214 E 23RD ST, CHEYENNE, WY 82001-3748
(307) 634-2273
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
990372
CO
363LF0000X
Family Nurse Practitioner
Primary
44363
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP-990372
COLORADO LICENSE NUMBER
CO
Enumeration date
04/24/2012
Last updated
04/10/2025
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