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NPI Code Detail

MEDICARE: MS. ANN M GRIMES PA-C

MEDICARE: MS. ANN M GRIMES PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant8527-023WI
2363A00000XPhysician Assistant085.005166IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649401985
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANN M GRIMES PA-C
Provider Business Mailing Address
First Line : 9200 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3522
Country : US
Telephone Number : 414-955-0350
Fax Number : 414-955-0094
Provider Business Practice Location Address
First Line : 9200 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3522
Country : US
Telephone Number : 414-955-0350
Fax Number : 414-955-0094
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2009
Last Update Date : 05/04/2026

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Directions to “ MS. ANN M GRIMES PA-C” Practice Location

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