Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 01210 | WV |
N | 207NS0135X | Procedural Dermatology | 01210 | WV |
NPI | 1417047242 |
---|---|
Provider Name | Ashley R Adkins Grimmett |
First Address | Barboursville, WV 25504 |
Second Address | Barboursville, WV 25504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 12/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001898831 | BCBS (01) | WV |