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General NPI Number Information
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NPI Number | 1861460289
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Entity Type | Individual
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Provider Name | DEBRA LEE GRINER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 3632 AMERICAN WAY
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City | CASPER
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State | WY
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Zip | 82604-3632
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Country | US
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Telephone | 307-233-7300
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Fax | 307-233-7301
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Provider Business Mailing Address
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Address Line | 3632 AMERICAN WAY A MESA PRIMARY CARE
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City | CASPER
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State | WY
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Zip | 82604-3632
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Country | US
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Telephone | 307-234-6765
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 21279.0310
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License Number State | WY
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