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NPI Code Detail

MEDICARE: MRS. PATRICIA GRIMES NP

MEDICARE: MRS. PATRICIA GRIMES NP
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
1163W00000XRegistered Nurse487-661NY
2363LF0000XFamily Nurse PractitionerF332935-1NY
3163W00000XRegistered NurseR181475MD
4363LF0000XFamily Nurse PractitionerR181475MD

General Provider Information

NPI Number : 1396841730
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA GRIMES NP
Provider Business Mailing Address
First Line : 2041 MARTIN LUTHER KING JR AVE SE
Second Line : STE 303
City : WASHINGTON
State : DC
Zip : 20020-7036
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9106 PINE VIEW LN
Second Line :
City : CLINTON
State : MD
Zip : 20735-3229
Country : US
Telephone Number : 301-856-2930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 08/15/2016

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