Healthcare Provider Details

I. General information

NPI: 1114595980
Provider Name (Legal Business Name): JUDITH SARAH GRIMM FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUDITH SARAH HUFF FNP-C

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4181 HIGHWAY 17
MURRELLS INLET SC
29576-5019
US

IV. Provider business mailing address

PO BOX 421718
GEORGETOWN SC
29442-4203
US

V. Phone/Fax

Practice location:
  • Phone: 843-652-3600
  • Fax: 843-652-3602
Mailing address:
  • Phone: 843-527-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number30455
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71011293A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: