Doctor Name: | MS. CLARICE ELIZABETH GRENS |
NPI Number: | 1053492678 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 002271 |
Business Practice Address: | 950 Campbell Ave West Haven, CT - 065162770 |
Business Phone Number: | 2039325711 |
Business Fax Number: | |
Mailing Address: | 56 Wedgewood Dr, EASTON |
State: | CT |
Postal Code: | 066122045 |
Phone Number: | 2039521010 |
Fax Number: | |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 02/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 002271 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |