Provider Demographics
NPI:1760369755
Name:GRIMM, DAYNA MARIE (CHW)
Entity type:Individual
Prefix:
First Name:DAYNA
Middle Name:MARIE
Last Name:GRIMM
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N 11TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CLOQUET
Mailing Address - State:MN
Mailing Address - Zip Code:55720-1652
Mailing Address - Country:US
Mailing Address - Phone:218-878-2895
Mailing Address - Fax:
Practice Address - Street 1:14 N 11TH ST STE 100
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-1652
Practice Address - Country:US
Practice Address - Phone:218-878-2895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker