Grimes, Teresa G

Grimes, Teresa G is an individual health care provider with primary practice located at 132 Hospital Dr , Watertown WI 53098-3304. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Grimes, Teresa G can be contacted via phone (920) 261-2020.

Contact Information

Primary practice address
132 Hospital Dr Watertown WI 53098-3304
Phone: (920) 261-2020
Fax: (920) 261-0457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 994-023 Wisconsin

Profile Details

NPI number 1619024494
LBN Legal business name Grimes, Teresa G
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jul 8th, 2007 - about 17 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 1619024494 NPPES
Wisconsin MEDICAID 41958600

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