Healthcare Provider Details

I. General information

NPI: 1760390280
Provider Name (Legal Business Name): MAKAYLA GRIM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 SAND CREEK DR APT 4310
MURRELLS INLET SC
29576-3509
US

IV. Provider business mailing address

178 SAND CREEK DR APT 4310
MURRELLS INLET SC
29576-3509
US

V. Phone/Fax

Practice location:
  • Phone: 843-520-9890
  • Fax:
Mailing address:
  • Phone: 843-520-9890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: