Grimes, Brent Alan

Grimes, Brent Alan is an individual health care provider with primary practice located at 3037 Corder Dr , Corinth MS 38834-6216. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Grimes, Brent Alan can be contacted via phone (662) 284-8565.

Contact Information

Primary practice address
3037 Corder Dr Corinth MS 38834-6216
Phone: (662) 284-8565
Fax: (662) 594-8366
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 16792 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN0000016792 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 810467 Mississippi

Profile Details

NPI number 1578561262
LBN Legal business name Grimes, Brent Alan
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Jun 27th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578561262 NPPES
Mississippi MEDICAID 004252075

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