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NPI Code Detail

MEDICARE: CYNTHIA ANN GRIMES NNP

MEDICARE:   CYNTHIA ANN GRIMES  NNP
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
1363LN0005XCritical Care Neonatal Nurse Practitioner68AZ

General Provider Information

NPI Number : 1598721110
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA ANN GRIMES NNP
Provider Business Mailing Address
First Line : 9402 N 36TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-3305
Country : US
Telephone Number : 602-973-7005
Fax Number :
Provider Business Practice Location Address
First Line : 901 E WILLETTA ST
Second Line : RM 3305
City : PHOENIX
State : AZ
Zip : 85006-2727
Country : US
Telephone Number : 602-239-2635
Fax Number : 602-239-2307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2006
Last Update Date : 07/08/2007

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Directions to “ CYNTHIA ANN GRIMES NNP” Practice Location

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