MEDICARE: JESSICA GRIMM

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	163W00000X	Registered Nurse	1687533	CO

General Provider Information

NPI Number	:	1821925983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA GRIMM

Provider Business Mailing Address
First Line	:	8950 WHITECLOVER ST
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80125-8054
Country	:	US
Telephone Number	:	303-906-8663
Fax Number	:	303-906-8663

Provider Business Practice Location Address
First Line	:	8950 WHITECLOVER ST
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80125-8054
Country	:	US
Telephone Number	:	303-906-8663
Fax Number	:	303-906-8663

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

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ JESSICA GRIMM ” Practice Location

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