MRS. NICOLE LEE GRIMM NP NPI 1104199843

NPI Information

  • NPI: 1104199843
  • Provider Name: MRS. NICOLE LEE GRIMM, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5409 VERN HOLMES DR
    STEVENS POINT, WI
    ZIP 54482
  • Phone: (715) 342-1185

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NPI Details

MRS. Nicole Lee Grimm, NP is a family nurse practitioner in Stevens Point, WI. MRS. Nicole Lee Grimm, NP NPI is 1104199843. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5409 VERN HOLMES DR
STEVENS POINT, WI
ZIP 54482-853
Phone: (715) 342-1185

The NPI 1104199843 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/10/2012 and was last updated on 11/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LX0106XNurse PractitionerOccupational Health7803-33WISCONSINNo
2363LF0000XNurse PractitionerFamily7803-33WISCONSINYes
3163W00000XRegistered Nurse184270-30WISCONSINNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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