National Provider Identifier Database

THERESA GRIMES, FNP-BC – NPI #1912910910
Family


Contact Information

THERESA GRIMES, FNP-BC
75 N COUNTRY RD
PORT JEFFERSON, NY11777-2119
Phone: 631-476-2847
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for THERESA GRIMES

NPI Number 1912910910
Credentials FNP-BC (Family Nurse Practitioner)
Entity Individual
Enumeration date 08/14/2006
Last updated 02/04/2011 - About 15 years ago
Sole proprietor1 No
Identifiers
  • NY License #: F332400-1
  • NY Medicaid: 01993700
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for THERESA GRIMES, FNP-BC

There are currently no reviews for THERESA GRIMES, FNP-BC


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