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Theresa Grimes, FNP-BC
Family Nurse Practitioner in Port Jefferson, New York
NPI 1912910910

Theresa Grimes is a Family Nurse Practitioner based in Coram, NY and is specialized in Family. Theresa Grimes practices in Port Jefferson, NY and has the professional credentials of FNP-BC. The NPI Number for Theresa Grimes is 1912910910 and holds a License No. F332400-1 (New York).

The current practice location address for Theresa Grimes is 75 N Country Rd, Port Jefferson, NY and can be reached out via phone at 631-476-2847.

Location: 75 N Country Rd, Port Jefferson, NY, 11727-1634
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912910910
Provider Name
Theresa Grimes
Credential
FNP-BC
Provider Entity Type
Individual
Gender
Female
Address
75 N Country Rd, Port Jefferson, NY, 11727-1634
Phone Number
631-476-2847
Fax Number
Provider Enumeration Date
08/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01993700 05 NY
institution
Provider Business Practice Location Address Details
Address
75 N Country Rd
City
Port Jefferson
State
New York
Zip
11777-2119
Phone Number
631-476-2847
Fax Number
person
Provider Business Mailing Address Details
Address
75 N Country Rd
City
Port Jefferson
State
New York
Zip
11777-2119
Phone Number
631-476-2847
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
F332400-1 (New York)
Definition
Definition to come...
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