Individual
MS. KIM M GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 815-6428
(402) 815-1565
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
110569
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100258661-00
—
NE
05
—
1275753683
—
IA
Enumeration date
04/26/2007
Last updated
08/13/2014
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