Individual
KELLIE Y GRILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(765) 284-7738
(765) 213-3713
Mailing address
PO BOX 1643, MUNCIE, IN 47308-1643
(765) 284-7735
(765) 213-3713
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
Primary
28105082A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000361956
ANTHEM PIN #
IN
Enumeration date
09/06/2006
Last updated
07/08/2007
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