Kristie M Grimes-Mallard, RN
Nurse Practitioner, Women's Health in Roxbury, Massachusetts
1730797077- Practice location
- 45 Dimock St, Roxbury, MA 02119-1208
- Phone
- 617-442-8800
- Fax
- 617-541-8334
- Last updated
- September 29, 2026
Kristie Michelle Grimes-Mallard is a Nurse Practitioner, Women's Health based in Roxbury, MA. Kristie Michelle Grimes-Mallard practices in Roxbury, MA and has the professional credentials of RN. The NPI Number for Kristie Michelle Grimes-Mallard is 1730797077 and holds a License No. RN2335640 (MA). The current practice location address for Kristie Michelle Grimes-Mallard is 45 Dimock St, Roxbury, MA 02119-1208 and can be reached out via phone at 617-442-8800 and via fax at 617-541-8334.
Provider Profile Details
- NPI Number
- 1730797077
- Provider Name
- Kristie Michelle Grimes-Mallard
- Credential
- RN
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 45 Dimock St, Roxbury, MA 02119-1208
- Phone Number
- 617-442-8800
- Fax Number
- 617-541-8334
- Primary Taxonomy
- Nurse Practitioner, Women's Health · 363LW0102X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 22, 2020
- Last Update Date
- September 29, 2026
- Certification Date
- September 29, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 45 Dimock St
Roxbury, MA 02119-1208 - City
- Roxbury
- State
- Massachusetts
- Zip
- 02119-1208
- Phone Number
- 617-442-8800
- Fax Number
- 617-541-8334
Provider Business Mailing Address Details
- Address
- 960 Massachusetts Avenue
Fl 2
Boston, MA 02118-2690 - City
- Boston
- State
- MA
- Zip
- 02118-2690
License Information
- License Number
- RN2335640
- License State
- MA
- Taxonomy
- Nurse Practitioner, Women's Health · 363LW0102X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kristie M Grimes-Mallard, RN?
The NPI number of Kristie M Grimes-Mallard, RN is 1730797077. It was assigned on July 22, 2020 and is currently active in the NPPES registry.
What is the specialty of Kristie M Grimes-Mallard, RN?
Kristie M Grimes-Mallard, RN is registered under the primary taxonomy Nurse Practitioner, Women's Health (code 363LW0102X), licensed in MA under license number RN2335640.
Where does Kristie M Grimes-Mallard, RN practice?
The practice location is 45 Dimock St, Roxbury, MA 02119-1208. The office can be reached at 617-442-8800 (phone) or 617-541-8334 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1730797077 directly on the NPPES registry website.