Provider Demographics
NPI:1275235467
Name:GRIMM, HANNAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:GRIMM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 E ERIE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOURI VALLEY
Mailing Address - State:IA
Mailing Address - Zip Code:51555-1619
Mailing Address - Country:US
Mailing Address - Phone:712-642-2747
Mailing Address - Fax:
Practice Address - Street 1:318 E ERIE ST
Practice Address - Street 2:
Practice Address - City:MISSOURI VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51555-1619
Practice Address - Country:US
Practice Address - Phone:712-642-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17651183500000X
IA24604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist