Provider Demographics
NPI:1114269875
Name:GRIMAN, KATHRYN LINDSAY
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LINDSAY
Last Name:GRIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6781 KOSTNER ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0519
Mailing Address - Country:US
Mailing Address - Phone:702-772-1325
Mailing Address - Fax:
Practice Address - Street 1:6781 KOSTNER ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0519
Practice Address - Country:US
Practice Address - Phone:702-772-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner