Provider Demographics
NPI:1114231578
Name:GRIMES, SUSAN RIGHTER (N P)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:RIGHTER
Last Name:GRIMES
Suffix:
Gender:F
Credentials:N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7G HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2966
Mailing Address - Country:US
Mailing Address - Phone:973-701-2552
Mailing Address - Fax:
Practice Address - Street 1:7G HERITAGE DR
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2966
Practice Address - Country:US
Practice Address - Phone:973-701-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN10205500363LX0001X
MO064680363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology