MEDICARE: MRS. ASHLEY MARIE GRINDLAY ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	RN197394	GA

General Provider Information

NPI Number	:	1114273984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY MARIE GRINDLAY ACNP

Provider Business Mailing Address
First Line	:	1490 MILSTEAD RD NE
Second Line	:	SUITE A
City	:	CONYERS
State	:	GA
Zip	:	30012-3823
Country	:	US
Telephone Number	:	770-922-2217
Fax Number	:	770-483-3206

Provider Business Practice Location Address
First Line	:	3970 DEPUTY BILL CANTRELL MEM
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-3069
Country	:	US
Telephone Number	:	678-513-2273
Fax Number	:	678-513-8869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	03/29/2022

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