| NPI | 1649460544 |
|---|---|
| Former Name | LISA KAYE GRIMES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005252) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3005252) |
| 363L00000X Nurse Practitioner (Licence: KY 5252P) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2022-12-01 |