Most Relevant Information
Provider Data
| NPI Number: | 1003227091 |
| Provider Name: | JESSICA GRIMM |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 174326-30 |
Most Important Dates
| Enumeration Date: | 05/13/2014 |
| Last Updated: | 05/13/2014 |
Provider Practice Location
514 RIVERVIEW AVE
WAUKESHA
WI
531883631
Practice Location Phone/Fax
| Phone: | 2628968459 |
| Fax: |
Provider Mailing Location
514 RIVERVIEW AVE
WAUKESHA
WI
531883631
Provider Mailing Phone/Fax
| Phone: | 2628968459 |
| Fax: |