Individual
MR. JOHN GRIMSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(800) 566-5659
Mailing address
14394 US HIGHWAY 6, SYRACUSE, IN 46567-9207
(574) 529-1212
(574) 528-5095
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28202216A
IN
363LF0000X
Family Nurse Practitioner
Primary
PENDING
IN
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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