Stacey Grimes

Debarred entity

Born 28 Sep 1972 (54 years old),United States. Named in 3 sanctions listings.

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Summary

License number: SP013433(PA ) RN538139(PA) 538142(NY) PROMISe #103103505

Sanctions and listings3

Effective
20 Dec 2017
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a4
Programme US-HHS-OIGoig.hhs.gov oig.hhs.gov
Effective
20 Dec 2017
Official designation
OIG BY WAY OF Pennsylvania Department of Human servicesUS Delaware Medicaid Sanctioned ProvidersUnited States
REVOCATION Active-Reporting Only-Felony Conviction
medicaid.dhss.delaware.gov
Listed
20 Dec 2017
Reciprocal
HHSUS SAM Procurement ExclusionsUnited StatesActive
Prohibition/Restriction
sam.gov

Positions held1

Period not retained
NURSE/NURSES AIDE (IND- LIC HC SERV PRO)

Identifiers1

Identifier	Number
NPI number	1831440122

Addresses2

ASHVILLE, NY 14710
2781 BUTTS ROAD, ASHVILLE, NY 14710

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