Healthcare Provider Details

I. General information

NPI: 1821925983
Provider Name (Legal Business Name): JESSICA GRIMM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 WHITECLOVER ST
LITTLETON CO
80125-8054
US

IV. Provider business mailing address

8950 WHITECLOVER ST
LITTLETON CO
80125-8054
US

V. Phone/Fax

Practice location:
  • Phone: 303-906-8663
  • Fax: 303-906-8663
Mailing address:
  • Phone: 303-906-8663
  • Fax: 303-906-8663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1687533
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: