Provider Demographics
NPI:1457433757
Name:GRIMALDO, REBECCA A (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:GRIMALDO
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Gender:F
Credentials:RN, FNP-C
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Mailing Address - Street 1:1051 PINELOCH DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2742
Mailing Address - Country:US
Mailing Address - Phone:281-990-9979
Mailing Address - Fax:281-990-9916
Practice Address - Street 1:1051 PINELOCH DR
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2742
Practice Address - Country:US
Practice Address - Phone:281-990-9979
Practice Address - Fax:281-990-9916
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2012-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX554544363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS71340Medicare UPIN