Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | DR.0060364 | CO |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD60734961 | WA |
NPI | 1326300864 |
---|---|
Provider Name | Courtney Marie Grimsrud |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 05/07/2019 |