Provider Demographics
NPI:1942980586
Name:GRILLS, ALLYNNA JEANETTE (PA-C)
Entity Type:Individual
Prefix:
First Name:ALLYNNA
Middle Name:JEANETTE
Last Name:GRILLS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 JAGGER LN
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-1139
Mailing Address - Country:US
Mailing Address - Phone:860-949-5021
Mailing Address - Fax:
Practice Address - Street 1:200 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2479
Practice Address - Country:US
Practice Address - Phone:860-676-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant