| Doctor Name: | CARYN GRIM |
| NPI Number: | 1104229699 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | TC294 |
| Business Practice Address: | 316 W 2nd St Morehead, KY - 403511550 |
| Business Phone Number: | 6067843771 |
| Business Fax Number: | 6067836966 |
| Mailing Address: | 316 W 2nd St, MOREHEAD |
| State: | KY |
| Postal Code: | 403511550 |
| Phone Number: | 6067843771 |
| Fax Number: | 6067802373 |
| NPI Enumeration Date: | 09/29/2014 |
| NPI Last Update Date: | 12/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | TC294 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |