Provider Demographics
NPI:1639137441
Name:GRINAR, DONALD MICHAEL (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:MICHAEL
Last Name:GRINAR
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-2011
Mailing Address - Country:US
Mailing Address - Phone:252-641-7150
Mailing Address - Fax:252-641-7477
Practice Address - Street 1:111 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-2011
Practice Address - Country:US
Practice Address - Phone:252-641-7150
Practice Address - Fax:252-641-7477
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200497363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
R94263Medicare UPIN
2599453Medicare ID - Type Unspecified