Provider Demographics
NPI:1033385570
Name:GRIER, RENEE SUSAN (ARNP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:SUSAN
Last Name:GRIER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25359 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERLAND KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-4517
Mailing Address - Country:US
Mailing Address - Phone:303-506-9395
Mailing Address - Fax:
Practice Address - Street 1:3142 NORTHSIDE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-8012
Practice Address - Country:US
Practice Address - Phone:305-294-4004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2140712363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303795900Medicaid