KIMBERLY JOAN GRZESIK MS RN AGACNP-BC NPI 1407381296

NPI Information

  • NPI: 1407381296
  • Provider Name: KIMBERLY JOAN GRZESIK, MS, RN, AGACNP-BC
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2150 GETTLER ST STE 455
    DYER, IN
    ZIP 46311
  • Phone: (219) 922-7159

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NPI Details

Kimberly Joan Grzesik, MS, RN, AGACNP-BC is a gerontology nurse practitioner in Dyer, IN with 35 years of experience. Kimberly Joan Grzesik, MS, RN, AGACNP-BC NPI is 1407381296. 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:

2150 GETTLER ST STE 455
DYER, IN
ZIP 46311-381
Phone: (219) 922-7159
Fax: (219) 922-4020

The NPI 1407381296 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 4/28/2017 and was last updated on 8/16/2024.

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
1363LA2200XNurse PractitionerAdult Health209015536ILLINOISNo
2363LG0600XNurse PractitionerGerontology71015407AINDIANAYes

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: 3/30/2025

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