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General NPI Number Information
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NPI Number | 1144678848
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Entity Type | Individual
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Provider Name | DEMETRICE GRIER APRN
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Gender | Male
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 3421 MIKE PADGETT HWY
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City | AUGUSTA
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State | GA
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Zip | 30906-3815
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Country | US
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Telephone | 706-432-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 328 SUMMERFIELD CIR
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City | GROVETOWN
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State | GA
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Zip | 30813-2206
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Country | US
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Telephone | 484-213-3865
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN253267
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN253267
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License Number State | GA
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