Individual
MRS. SHANNON A GRIME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3400 OLENTANGY RIVER RD, COLUMBUS, OH 43202-1523
(614) 754-5500
(614) 457-9519
Mailing address
3400 OLENTANGY RIVER RD, COLUMBUS, OH 43202-1523
(614) 754-5500
(614) 457-9519
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
312107
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.18361-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13586175
CAQH
OH
Enumeration date
09/22/2015
Last updated
11/10/2015
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