Provider Demographics
NPI:1689348443
Name:GRIMES, CARLEE MAE
Entity type:Individual
Prefix:
First Name:CARLEE
Middle Name:MAE
Last Name:GRIMES
Suffix:
Gender:F
Credentials:
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Mailing Address - Street 1:2431 E 61ST ST STE 500
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-1208
Mailing Address - Country:US
Mailing Address - Phone:918-582-6800
Mailing Address - Fax:918-582-6060
Practice Address - Street 1:512 N FRANKLIN ST FL 2
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-2490
Practice Address - Country:US
Practice Address - Phone:918-582-6800
Practice Address - Fax:918-582-6060
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2024-11-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant