Aims, Llc | |
417 S Whitlock St Bremen IN 46506-1626 | |
(574) 546-0330 | |
(574) 747-8650 |
Full Name | Aims, Llc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 417 S Whitlock St, Bremen, Indiana |
Authorized Official Name and Position | Kashif A. Janjua (PRESIDENT & CEO) |
Authorized Official Contact | 4437399997 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Aims, Llc 111 E 3rd St Unit 764 Mishawaka IN 46546-4038 Ph: (574) 208-9007 | Aims, Llc 417 S Whitlock St Bremen IN 46506-1626 Ph: (574) 546-0330 |
NPI Number | 1376072785 |
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Provider Enumeration Date | 06/08/2017 |
Last Update Date | 09/11/2023 |
Certification Date | 09/11/2023 |
Medicare PECOS PAC ID | 6406126572 |
---|---|
Medicare Enrollment ID | O20170721002478 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376072785 | NPI | - | NPPES |
Provider Name | Husam A Baki |
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Provider Type | Practitioner - Allergy/immunology |
Provider Identifiers | NPI Number: 1316129695 PECOS PAC ID: 3678464989 Enrollment ID: I20040324000428 |
Provider Name | Philip Creps |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1649284688 PECOS PAC ID: 8820084544 Enrollment ID: I20040420001471 |
Provider Name | Cheryl V Facey-graham |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730377623 PECOS PAC ID: 0941285365 Enrollment ID: I20040621001053 |
Provider Name | Edduyn Ariel Figueroa |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1265462410 PECOS PAC ID: 0840264545 Enrollment ID: I20040819001099 |
Provider Name | Charles E Heinsen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194768960 PECOS PAC ID: 5496668683 Enrollment ID: I20050316000426 |
Provider Name | Lisa Darlene Stults |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033181599 PECOS PAC ID: 4880628486 Enrollment ID: I20050922001140 |
Provider Name | Donna Maria Bard |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1912925827 PECOS PAC ID: 4688682354 Enrollment ID: I20060323000017 |
Provider Name | Catherine Herod |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1164587242 PECOS PAC ID: 1557379740 Enrollment ID: I20060329000759 |
Provider Name | Mario M Robbins |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1538151717 PECOS PAC ID: 0143320945 Enrollment ID: I20070710000075 |
Provider Name | Richard Payne |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1710104088 PECOS PAC ID: 6507956596 Enrollment ID: I20071213000786 |
Provider Name | Geoffrey O Onyeukwu |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1093724007 PECOS PAC ID: 3375610025 Enrollment ID: I20080922000329 |
Provider Name | Abdulateef O Aregbe |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1972756245 PECOS PAC ID: 1254482763 Enrollment ID: I20090623000685 |
Provider Name | Olufunke L Brimmo-longe |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1568418176 PECOS PAC ID: 4183686413 Enrollment ID: I20091005000071 |
Provider Name | Michelle K Boswell |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1649404948 PECOS PAC ID: 2163569047 Enrollment ID: I20091026000488 |
Provider Name | Mallikarju N Patta |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1164499554 PECOS PAC ID: 2365472313 Enrollment ID: I20091210000122 |
Provider Name | Lynnea Carder |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1639214455 PECOS PAC ID: 7719083179 Enrollment ID: I20100213000017 |
Provider Name | John A Israel |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1457429722 PECOS PAC ID: 1658401104 Enrollment ID: I20100610000551 |
Provider Name | Olaniyi Osuntokun |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1548375058 PECOS PAC ID: 9739362633 Enrollment ID: I20110331000119 |
Provider Name | Renee E Buskirk |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1619275807 PECOS PAC ID: 3577747260 Enrollment ID: I20110404000739 |
Provider Name | Kawanya E Muhammad |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043592694 PECOS PAC ID: 9133391170 Enrollment ID: I20111017000388 |
Provider Name | Elizabeth Jackson |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1275885527 PECOS PAC ID: 9931347051 Enrollment ID: I20130531000534 |
Provider Name | Adeshola W Afolabi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689982803 PECOS PAC ID: 5193968584 Enrollment ID: I20130904000673 |
Provider Name | India L Samuels |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407283294 PECOS PAC ID: 9537397187 Enrollment ID: I20140106001391 |
Provider Name | Paul N Kuria |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710210521 PECOS PAC ID: 0941485999 Enrollment ID: I20140610002418 |
Provider Name | Lensa G Girsha |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013242080 PECOS PAC ID: 6204058647 Enrollment ID: I20141119001367 |
Provider Name | Vinicius Teixeira |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1841516119 PECOS PAC ID: 0143442541 Enrollment ID: I20141120000652 |
Provider Name | Joseph Moto |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689072209 PECOS PAC ID: 5092030619 Enrollment ID: I20150202001817 |
Provider Name | Kimberly Anne Artman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710229398 PECOS PAC ID: 8426373226 Enrollment ID: I20150219002168 |
Provider Name | Kashif A Janjua |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1558522730 PECOS PAC ID: 5597938282 Enrollment ID: I20150316002377 |
Provider Name | Melissa Anthony |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780079004 PECOS PAC ID: 3971823055 Enrollment ID: I20150514000277 |
Provider Name | Noadiah Malott |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962740365 PECOS PAC ID: 2163739160 Enrollment ID: I20150923000311 |
Provider Name | Tara Pousson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265810584 PECOS PAC ID: 6406166537 Enrollment ID: I20151102002296 |
Provider Name | Linda Omalley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780748913 PECOS PAC ID: 5698078426 Enrollment ID: I20160128000118 |
Provider Name | Azubike Nwokedi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336507094 PECOS PAC ID: 8729383583 Enrollment ID: I20160217000173 |
Provider Name | Faye E Rupert |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396081063 PECOS PAC ID: 2365740149 Enrollment ID: I20160411002323 |
Provider Name | Tara L Stanton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194175554 PECOS PAC ID: 7810288560 Enrollment ID: I20160628000223 |
Provider Name | Maria Gootee |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1710330899 PECOS PAC ID: 1052605961 Enrollment ID: I20160815002281 |
Provider Name | Marian K Ramsey Ford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326579574 PECOS PAC ID: 7517243959 Enrollment ID: I20170419000679 |
Provider Name | Tammy J Gaska |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679014021 PECOS PAC ID: 6002187390 Enrollment ID: I20170804000833 |
Provider Name | Rosaline Richardson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790297463 PECOS PAC ID: 5991062515 Enrollment ID: I20171206001048 |
Provider Name | Tammie R Maiden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265632566 PECOS PAC ID: 4688960339 Enrollment ID: I20171218003208 |
Provider Name | Denford Mujeye |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326566142 PECOS PAC ID: 4688937352 Enrollment ID: I20180410002537 |
Provider Name | Ayodeji I Ogunleye |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1629485107 PECOS PAC ID: 0345504767 Enrollment ID: I20180510000470 |
Provider Name | Detonya Armstrong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346754835 PECOS PAC ID: 4880852391 Enrollment ID: I20180613000428 |
Provider Name | Mary B Mammen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134615834 PECOS PAC ID: 7719234236 Enrollment ID: I20180716000633 |
Provider Name | Paula Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033600390 PECOS PAC ID: 0749335602 Enrollment ID: I20180801002988 |
Provider Name | Lynda Nathan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558795732 PECOS PAC ID: 0244474914 Enrollment ID: I20180827003252 |
Provider Name | Kaley Michelle Marino |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376021725 PECOS PAC ID: 3779834064 Enrollment ID: I20180926000520 |
Provider Name | Olabisi Fajana |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780164053 PECOS PAC ID: 7911258231 Enrollment ID: I20180926002067 |
Provider Name | Constance R Bullock |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104306620 PECOS PAC ID: 6002169679 Enrollment ID: I20181029001300 |
Provider Name | Ngozika Adindu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659862266 PECOS PAC ID: 9335492933 Enrollment ID: I20181030002657 |
Provider Name | Sarah Ann Williams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528542818 PECOS PAC ID: 4789938408 Enrollment ID: I20181116000098 |
Provider Name | Jasper Mukwada |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558815787 PECOS PAC ID: 4981992856 Enrollment ID: I20190109002136 |
Provider Name | Jennifer W Njihia |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073015723 PECOS PAC ID: 8426394271 Enrollment ID: I20190115002711 |
Provider Name | John Walsh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316427560 PECOS PAC ID: 2062759764 Enrollment ID: I20190201001873 |
Provider Name | Jordynn O Tibbs |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962996314 PECOS PAC ID: 6800134388 Enrollment ID: I20190207001053 |
Provider Name | Alana Urness |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659810877 PECOS PAC ID: 1557646064 Enrollment ID: I20190403001245 |
Provider Name | Srikanth Dev Ravindran |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1417209933 PECOS PAC ID: 9638485188 Enrollment ID: I20190807000148 |
Provider Name | Priscah Ouma Odongo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194372409 PECOS PAC ID: 4284963141 Enrollment ID: I20190903001570 |
Provider Name | Regina Lynn Yoder |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093272593 PECOS PAC ID: 5395074264 Enrollment ID: I20190903001949 |
Provider Name | Jennifer Anne Harmon-nary |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1023664406 PECOS PAC ID: 9436488293 Enrollment ID: I20190904003053 |
Provider Name | Stephanie Howard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821574187 PECOS PAC ID: 9133459316 Enrollment ID: I20191001003381 |
Provider Name | Jennifer Leigh Huff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861040693 PECOS PAC ID: 4385975226 Enrollment ID: I20191008002122 |
Provider Name | Yulia Abair |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265085286 PECOS PAC ID: 2365773504 Enrollment ID: I20191018002033 |
Provider Name | Jami Lynn Cecil |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669930566 PECOS PAC ID: 7315279957 Enrollment ID: I20191030003202 |
Provider Name | Rana Magill Stoops |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134775463 PECOS PAC ID: 1951734052 Enrollment ID: I20191203003099 |
Provider Name | Patrick Murathimi Mutugu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588205231 PECOS PAC ID: 3678907581 Enrollment ID: I20191231002502 |
Provider Name | Stephanie Ann Owen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184263105 PECOS PAC ID: 3476989070 Enrollment ID: I20200130000093 |
Provider Name | Deina S Nemiary |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1851556856 PECOS PAC ID: 1456500321 Enrollment ID: I20200317000318 |
Provider Name | Deborah Ann Mcglasson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598021503 PECOS PAC ID: 1759710122 Enrollment ID: I20200406002206 |
Provider Name | Yvonne Chaadulia Lindeire |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184255093 PECOS PAC ID: 2769812684 Enrollment ID: I20200416002910 |
Provider Name | Wesley David Runkle |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1437445046 PECOS PAC ID: 4587086574 Enrollment ID: I20200619002515 |
Provider Name | Keva Swopes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083257695 PECOS PAC ID: 7113340084 Enrollment ID: I20200710000650 |
Provider Name | Tanesha N Turner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487148946 PECOS PAC ID: 9638414287 Enrollment ID: I20200721000450 |
Provider Name | David Bryan Nolte |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245860436 PECOS PAC ID: 0749607232 Enrollment ID: I20200828001607 |
Provider Name | Magdalene Oluwamayowa Bambo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790394922 PECOS PAC ID: 8921425992 Enrollment ID: I20200908000087 |
Provider Name | Mya Yee Nandar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710584834 PECOS PAC ID: 5092134312 Enrollment ID: I20201006000084 |
Provider Name | Larry Edwin Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659979268 PECOS PAC ID: 0446660526 Enrollment ID: I20201030000476 |
Provider Name | Rosemary Gathungu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326650052 PECOS PAC ID: 1557772209 Enrollment ID: I20201201001958 |
Provider Name | Adam D Dell |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1750623989 PECOS PAC ID: 0446571327 Enrollment ID: I20201208002360 |
Provider Name | Juana Jones-felton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275130437 PECOS PAC ID: 1052723129 Enrollment ID: I20201214002190 |
Provider Name | Dorothy Bodur |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063019040 PECOS PAC ID: 3678986700 Enrollment ID: I20210111002171 |
Provider Name | Andrea L Brandon Menefee |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1396864757 PECOS PAC ID: 3072928605 Enrollment ID: I20210212001073 |
Provider Name | Sheryl Ann Vinci |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710403282 PECOS PAC ID: 6507196359 Enrollment ID: I20210218001457 |
Provider Name | Latrisha T Hampton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891265898 PECOS PAC ID: 5193068138 Enrollment ID: I20210218001760 |
Provider Name | Mary Galetti |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619586070 PECOS PAC ID: 8527474337 Enrollment ID: I20210302002716 |
Provider Name | Kimberly Kay Dietrich |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497349666 PECOS PAC ID: 5395151609 Enrollment ID: I20210311001849 |
Provider Name | Aurora Munoz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053887620 PECOS PAC ID: 4688909914 Enrollment ID: I20210324001943 |
Provider Name | Taletha K Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689181372 PECOS PAC ID: 0749549665 Enrollment ID: I20210329001501 |
Provider Name | Kelly Marie Schultz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558956755 PECOS PAC ID: 8921415449 Enrollment ID: I20210330001886 |
Provider Name | Breanne Nicole Kowalski |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669063814 PECOS PAC ID: 5799184271 Enrollment ID: I20210603002029 |
Provider Name | Nicole Klasey |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1356482475 PECOS PAC ID: 2961786603 Enrollment ID: I20210729002222 |
Provider Name | Rhoda Agaji Ogar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336683028 PECOS PAC ID: 7810391844 Enrollment ID: I20210812000853 |
Provider Name | Michael Lane |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457932337 PECOS PAC ID: 5890194401 Enrollment ID: I20220919000980 |
Provider Name | Vanessa Marie Ross |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629798194 PECOS PAC ID: 1254717424 Enrollment ID: I20220927000279 |
Provider Name | Juanita Marie Roberts |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073237202 PECOS PAC ID: 0042688764 Enrollment ID: I20221130000261 |
Provider Name | Katherine Kuypers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942938261 PECOS PAC ID: 4486026846 Enrollment ID: I20230211000535 |
Provider Name | Brian Russell Phillips |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326752221 PECOS PAC ID: 3173997608 Enrollment ID: I20230323000198 |
Provider Name | Beryl Chiboyiwa |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427745926 PECOS PAC ID: 6800254996 Enrollment ID: I20230622000268 |
Provider Name | Saby Kirpal |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225741838 PECOS PAC ID: 2365804184 Enrollment ID: I20230810003211 |
Provider Name | Brian Patrick Grimley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427736362 PECOS PAC ID: 0840644969 Enrollment ID: I20230922003275 |