Grimm, Nichole Suzanne
Grimm, Nichole Suzanne is an individual health care provider with primary practice located at 30544 Highway 200 Ste 101, Ponderay ID 83852-5005. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Grimm, Nichole Suzanne can be contacted via phone (208) 263-6300.Contact Information
Primary practice address
30544 Highway 200 Ste 101
Ponderay ID 83852-5005
Phone: (208) 263-6300
Fax: (208) 263-6355
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | NP-1113A | Idaho |
Profile Details
| NPI number | 1669756813 |
|---|---|
| LBN Legal business name | Grimm, Nichole Suzanne |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2011 |
| Last updated | Dec 21st, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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