Cary Grinold, FNP,CDE

Individual provider Active NPI Family Nurse Practitioner · Kings Bay, GA

NPI 1104894294 · NPPES record last updated Feb 16, 2011

Key facts

NPI
1104894294
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
R22890 (NM)
Practice address
881 Uss James Madison Road
Naval Ambulatory Care Center
Kings Bay, GA 31547
Phone
(912) 573-6583
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R22890NMMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R22890 NM Yes

Addresses

Primary practice location

881 Uss James Madison Road
Naval Ambulatory Care Center
Kings Bay, GA 31547

Mailing address

881 Uss James Madison Road
Naval Ambulatory Care Center
Kings Bay, GA 31547
Phone (912) 573-6583

Other providers in Kings Bay, GA

All providers in Kings Bay, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.