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NPI Code Detail

MEDICARE: CHIRIE LEDDELL GRIMES

MEDICARE:   CHIRIE LEDDELL GRIMES
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2182152526OTHERARRSPMI

General Provider Information

NPI Number : 1427393727
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHIRIE LEDDELL GRIMES
Provider Business Mailing Address
First Line : 7107 W 12TH ST STE 201
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-2451
Country : US
Telephone Number : 501-663-1837
Fax Number :
Provider Business Practice Location Address
First Line : 7107 W 12TH ST STE 201
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-2451
Country : US
Telephone Number : 501-663-1837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2012
Last Update Date : 11/28/2012

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Directions to “ CHIRIE LEDDELL GRIMES ” Practice Location

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