Provider Demographics
NPI:1740361567
Name:GRIMES, GEANNE R (DC)
Entity type:Individual
Prefix:DR
First Name:GEANNE
Middle Name:R
Last Name:GRIMES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 14TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-5009
Mailing Address - Country:US
Mailing Address - Phone:402-564-2622
Mailing Address - Fax:402-563-3717
Practice Address - Street 1:2323 14TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-5009
Practice Address - Country:US
Practice Address - Phone:402-564-2622
Practice Address - Fax:402-563-3717
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00083250OtherRAILROAD MEDICARE
NE9907OtherMIDLANDS CHOICE
NE09767OtherBLUE CROSS
NE09767OtherBLUE CROSS
NET40136Medicare UPIN