Provider Demographics
NPI:1922863612
Name:GRINKLEY, KIARA YUDELKA (RN, CST)
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:YUDELKA
Last Name:GRINKLEY
Suffix:
Gender:F
Credentials:RN, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LEWISTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3709
Mailing Address - Country:US
Mailing Address - Phone:617-461-0752
Mailing Address - Fax:
Practice Address - Street 1:50 LEWISTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02136-3709
Practice Address - Country:US
Practice Address - Phone:617-461-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula