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General NPI Number Information
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NPI Number | 1780649228
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Entity Type | Individual
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Provider Name | ANA GRYNWALD ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 200 E CHESTNUT ST STE 303
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City | LOUISVILLE
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State | KY
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Zip | 40202-1831
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Country | US
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Telephone | 502-629-5552
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Fax | 502-629-3132
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Provider Business Mailing Address
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Address Line | PO BOX 950202
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City | LOUISVILLE
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State | KY
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Zip | 40295-0202
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Country | US
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Telephone | 502-272-5100
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Fax | 502-272-5116
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 60951
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5401P
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3005401
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License Number State | KY
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