Grimaldi, Tara Jill

Grimaldi, Tara Jill is an individual health care provider with primary practice located at 20930 W 151St , Olathe KS 66061. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Grimaldi, Tara Jill can be contacted via phone (913) 782-2525.

Contact Information

Primary practice address
20930 W 151St Olathe KS 66061
Fax: (913) 782-9307
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 04-32569 Kansas

Profile Details

NPI number 1043414105
LBN Legal business name Grimaldi, Tara Jill
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2007
Last updated Nov 7th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043414105 NPPES
Kansas MEDICAID 200441540A

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