Individual
MACKENZIE LINN GRIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 ARCADE AVE STE 230, ELKHART, IN 46514-2485
(572) 522-6565
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300118511
—
IN
Enumeration date
07/08/2025
Last updated
10/20/2025
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