MEDICARE: JULIANA GRIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	78113	ME

General Provider Information

NPI Number	:	1518824044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA GRIM

Provider Business Mailing Address
First Line	:	189 LINE ST APT A
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29403-6544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	189 LINE ST APT A
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29403-6544
Country	:	US
Telephone Number	:	978-914-0656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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