Provider Demographics
NPI:1831966027
Name:GRIMES, HAYAT AMEERA
Entity type:Individual
Prefix:
First Name:HAYAT
Middle Name:AMEERA
Last Name:GRIMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:JOSEPINE
Other - Last Name:SALMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:5210 44TH AVE S APT 107
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4460
Mailing Address - Country:US
Mailing Address - Phone:484-557-0953
Mailing Address - Fax:
Practice Address - Street 1:5210 44TH AVE S APT 107
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4460
Practice Address - Country:US
Practice Address - Phone:484-557-0953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider