Individual
BECKY L GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3201 PIONEERS BLVD STE 304, LINCOLN, NE 68502-5963
(402) 483-2987
(402) 483-2980
Mailing address
3201 PIONEERS BLVD STE 304, LINCOLN, NE 68502-5963
(402) 483-2987
(402) 483-2980
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25300
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37819
BCBS
NE
05
—
47068394113
—
NE
Enumeration date
08/23/2006
Last updated
06/10/2010
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