| NPI | 1700167822 |
|---|---|
| Former Name | TIFFANY A GRIMES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185508) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011520) |
| 363L00000X Nurse Practitioner (Licence: VA 0024185508) | |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2024-07-04 |