Provider Demographics
NPI:1902492820
Name:GRIEB, CAROL LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LYNN
Last Name:GRIEB
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E MARSHALL ST STE 205
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4453
Mailing Address - Country:US
Mailing Address - Phone:610-903-6200
Mailing Address - Fax:610-903-6201
Practice Address - Street 1:600 E MARSHALL ST STE 205
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4453
Practice Address - Country:US
Practice Address - Phone:610-903-6200
Practice Address - Fax:610-903-6201
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022493363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty