Individual provider · Type 1 NPI
Antoine Lamont Grider, RN, CCM
Case Management Registered Nurse · Portsmouth, VA
NPI number
1780405282
Active
Practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Fax (757) 444-8541
Mailing address
961 Olmstead St
Chesapeake, VA 23323-1463
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Management Registered Nurse Primary | 163WC0400X | 0001157257 (VA) |
Case Management Registered Nurse: Definition to come...
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About NPI 1780405282
Antoine Lamont Grider, RN, CCM's National Provider Identifier is 1780405282, issued on Oct 18, 2024. The primary taxonomy on file is Case Management Registered Nurse (163WC0400X), and the practice location is in Portsmouth, VA. The record was last updated on Oct 18, 2024.