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ANNETTE RENAE GRIMSHAW
1500 14TH ST W WILLISTON ND 588014077
ANNETTE RENAE GRIMSHAW is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1104949338. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 1557386216. The primary specialty is OPTOMETRY. The organization is WILLISTON BASIN EYECARE ASSOCIATES PC. The address is 1500 14TH ST W, , WILLISTON, ND, 588014077. The zip code is 588014077.
|Nation Provider ID||1104949338|
|PAC ID by PECOS||1557386216|
|Professional Enrollment ID||I20150804003977|
|Name||ANNETTE RENAE GRIMSHAW|
|Medical School Name||INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY|
|All secondary specialties|
|Organization Name||WILLISTON BASIN EYECARE ASSOCIATES PC|
|Group Practice PAC ID||4183892995|
|Number of Group Practice members||6|
|Address||1500 14TH ST W, , WILLISTON, ND, 588014077|
|Hospital affiliation LBN|