Provider Demographics
NPI:1548065212
Name:GUIMARAES GRINDO, TAILYNE
Entity type:Individual
Prefix:
First Name:TAILYNE
Middle Name:
Last Name:GUIMARAES GRINDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 WHEAT STRAW CT
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-5124
Mailing Address - Country:US
Mailing Address - Phone:919-548-3530
Mailing Address - Fax:
Practice Address - Street 1:59 WHEAT STRAW CT
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-5124
Practice Address - Country:US
Practice Address - Phone:919-548-3530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program