NICHOLE SUZANNE GRIMM

PONDERAY, ID
NPI1669756813
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: ID  NP-1113A)
Enumeration Date2011-10-06
Last Update Date2016-12-21
Business Address
-- NICHOLE SUZANNE GRIMM NP
30544 HIGHWAY 200 STE 101
PONDERAY, ID 83852-5005
Phone number: 208-263-6300
Mailing Address
-- NICHOLE SUZANNE GRIMM NP
30544 HIGHWAY 200 STE 102
PONDERAY, ID 83852-5005
Phone number: 208-263-6300
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