Provider Demographics
NPI:1881581155
Name:GRIMM, NATHAN DEAN
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:DEAN
Last Name:GRIMM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 THUNDER HILL RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-7969
Mailing Address - Country:US
Mailing Address - Phone:402-719-1967
Mailing Address - Fax:
Practice Address - Street 1:1850 SW PLAZA SHOPS LN STE D
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7168
Practice Address - Country:US
Practice Address - Phone:515-508-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health