Healthcare Provider Details

I. General information

NPI: 1265089072
Provider Name (Legal Business Name): ERIN ARMENDA GRIMMITT AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 MONTGOMERY BLVD NE STE 215
ALBUQUERQUE NM
87111-2579
US

IV. Provider business mailing address

6101 IMPERATA ST NE APT 2526
ALBUQUERQUE NM
87111-8025
US

V. Phone/Fax

Practice location:
  • Phone: 505-431-4212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: