Individual
MRS. NADINE GRUNDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
258 SW AMESBURY AVE, PORT ST LUCIE, FL 34953-6964
(772) 878-5639
Mailing address
258 SW AMESBURY AVE, PORT ST LUCIE, FL 34953-6964
(772) 878-5639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
627176-1
NY
163W00000X
Registered Nurse
Primary
RN 9306882
FL
Other
Enumeration date
09/23/2012
Last updated
09/23/2012
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