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NPI Code Detail

MEDICARE: DR. LAURIE GRISSMAN MCCUEN ARNP

MEDICARE:  DR. LAURIE GRISSMAN MCCUEN  ARNP
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
1363L00000XNurse PractitionerARNP3104732FL

Other Identifiers

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

General Provider Information

NPI Number : 1912099771
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURIE GRISSMAN MCCUEN ARNP
Provider Business Mailing Address
First Line : 938 SW MARTIN DOWNS BLVD
Second Line :
City : PALM CITY
State : FL
Zip : 34990-2816
Country : US
Telephone Number : 772-221-7620
Fax Number : 772-221-9903
Provider Business Practice Location Address
First Line : 938 SW MARTIN DOWNS BLVD
Second Line :
City : PALM CITY
State : FL
Zip : 34990-2816
Country : US
Telephone Number : 772-221-7620
Fax Number : 772-221-9903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 09/24/2018

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