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1194583609
KIRA LEE-LIN GRIDLEY
FAYETTEVILLE, NY
NPI
1194583609
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NY F351912-01)
Enumeration Date
2024-03-08
Last Update Date
2024-03-08
Business Address
KIRA LEE-LIN GRIDLEY FNP
6870 E GENESEE ST
FAYETTEVILLE, NY 13066-1031
Phone number: 315-679-4367
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Mailing Address
KIRA LEE-LIN GRIDLEY FNP
5476 TOWNSEND RD
MANLIUS, NY 13104-9754
Phone number: 315-243-6183
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