Provider Demographics
NPI:1952695728
Name:MCGRILLEN, CAROLINE SARAH (RNIBCLC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:SARAH
Last Name:MCGRILLEN
Suffix:
Gender:F
Credentials:RNIBCLC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:SARAH
Other - Last Name:MCGRILLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN IBCLC
Mailing Address - Street 1:160 URBANO DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-2823
Mailing Address - Country:US
Mailing Address - Phone:415-337-1365
Mailing Address - Fax:
Practice Address - Street 1:160 URBANO DR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-2823
Practice Address - Country:US
Practice Address - Phone:415-440-3291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457687163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse