Individual
DORIS ELAINE GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
830 WASHINGTON ST, WATERTOWN, NY 13601-4034
(315) 449-0513
Mailing address
PO BOX 2005, EAST SYRACUSE, NY 13057-4505
(315) 449-0513
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
RN552231
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
498642
NY
Other
Enumeration date
06/09/2005
Last updated
05/16/2020
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