Kristie Michelle Grimes-Mallard, RN
NPI #1730797077 in Roxbury, Massachusetts
Provider Information
- NPI Number
- 1730797077
- Entity Type
- Individual
- Name
- Kristie Michelle Grimes-Mallard, RN
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner
- Credential
- RN
- Enumeration Date
- Jul 22, 2020
- Last Updated
- Nov 16, 2020
Practice Location
- Address
- 45 DIMOCK ST
- City
- Roxbury
- State
- Massachusetts
- ZIP Code
- 02119-1208
- Phone
- (617) 442-8800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse |
| Nurse Practitioner |
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