Provider Demographics
NPI:1245269588
Name:GRINDELL, PATRICIA M (APRN-BC, ADM)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:M
Last Name:GRINDELL
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Gender:F
Credentials:APRN-BC, ADM
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-973-1750
Practice Address - Fax:508-235-6658
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-09-08
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Provider Licenses
StateLicense IDTaxonomies
MARN141286363L00000X
MA141286363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0700703Medicaid
MA0700703Medicaid
MAQ18693Medicare UPIN