| NPI | 1235553801 |
|---|---|
| Former Name | PEGGY ELOISE GRIMES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201804601NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV APRN002061) |
| 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02348) | |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2018-08-17 |