Individual
KATHLEEN GRIMAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
469 MIGEON AVE, TORRINGTON, CT 06790-4643
(860) 489-0931
(860) 489-3325
Mailing address
469 MIGEON AVE, TORRINGTON, CT 06790-4643
(860) 489-0931
(860) 489-3325
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
000298
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004247872
—
CT
01
—
071834
MEDICARE LEGACY #
CT
Enumeration date
03/06/2006
Last updated
11/14/2011
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